Surgical Outcomes of Rhegmatogenous Retinal Detachment with Different Peripheral Vitreous-Shaving Procedures

Koichi Nishitsuka, Madoka Nakamura, Katsuhiro Nishi, Hiroyuki Namba, Yutaka Kaneko, Hidetoshi Yamashita Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medicine, Yamagata, JapanCorrespondence: Koichi NishitsukaDepartment of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medicine, Yamagata City, JapanTel +81 23-628-5374Fax +81 23-528-5377Email mlc12186@nifty.comPurpose: To compare the surgical outcomes of vitreous surgery for rhegmatogenous retinal detachment (RRD) after two different peripheral vitreous-shaving techniques are performed.Methods: We reviewed 269 eyes with RRD that were treated with a 25-gauge vitrectomy by a single surgeon between June 2015 and May 2020. The exclusion criteria for the proposed air tamponade selection were as follows: more than two weeks since RRD onset, giant retinal tears, a history of complications following cataract surgery, high myopia, and proliferative vitreoretinopathy classified as grade C or higher. We examined the differences in the therapeutic effect between shaving under slit lamp microscope illumination (group A) and shaving under a wide-angle viewing system (group B).Results: A total of 269 eyes were included in this study, with 146 eyes in group A and 123 eyes in group B. The primary anatomical success rates did not differ between group A (97.3%; 142/146 eyes) and group B (97.6%; 120/123 eyes; P = 0.102). However, the surgical time was significantly longer in group A (60.2 ± 17.1 min) than that in group B (46.9 ± 12.6 min) (P < 0.001). The multiple linear regression analysis revealed that surgical time was significantly correlated with using the wide-angle noncontact viewing system for vitreous shaving (adjusted R2 = 0.248; beta [standard partial regression coefficient] = − 0.447, P < 0.001), the number of retinal breaks (beta = 0.182, P = 0.001), and the quadrant of retinal detachment (beta = 0.205, P < 0.001).Conclusion: The surgical outcomes were similar regardless of the shaving procedure performed, and the surgical time was shortened by using the wide-angle noncontact viewing system for vitreous shaving.Keywords: vitrectomy, vitreous base, posterior vitreous-cortex detachment, slit lamp microscope illumination, wide-angle noncontact viewing system