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ALL-PROBE VITRECTOMY DISSECTION TECHNIQUES FOR DIABETIC TRACTIONAL RETINAL DETACHMENTS: Lift and Shave

Berrocal, María, H., MD

doi: 10.1097/IAE.0000000000001884
Duke 2017: PDF Only

To describe a technique to relieve traction, remove fibrovascular tissue, and reattach the retina in cases of tractional retinal detachment secondary to complications of diabetes using only the vitrectomy probe.

Purpose: To describe the all-probe lift and shave technique to remove fibrovascular tissue and repair diabetic retinal detachments. Anatomical and visual acuity outcomes with this technique are presented.

Methods: In this single surgeon, retrospective review of a consecutive series of eyes with tractional retinal detachment associated with diabetic retinopathy repaired with probe-only dissection techniques. The technique of alternating aspiration with blunt dissection and shaving with the vitrectomy probe is described and shown in video.

Results: Forty-two eyes with tractional retinal detachment were successfully repaired and achieved anatomical attachment with the lift and shave technique. Twenty eyes were repaired with 27 g vitrectomy and 22 eyes with 25 g. Ninety percent of eyes improved two or more Snellen lines. Minimum follow-up was 6 months. Complications included iatrogenic breaks in one eye (5%), nonclearing vitreous hemorrhage in four eyes (9%), and reoperation in three eyes (7%) for epiretinal membranes.

Conclusion: The all-probe lift and shave technique of fibrovascular dissection is a streamlined approach for the management of tractional retinal detachments. Advantages include the need for minimal ancillary instrumentation, increased efficiency, and reduced complications.

Berrocal and Associates, San Juan, Puerto Rico.

Reprint requests: María H. Berrocal, MD, Berrocal and Associates, 140 de Diego Avenue, Suite 404, San Juan, PR, Puerto Rico 00907; e-mail: mariahberrocal@hotmail.com

Presented at 20th Advanced Vitreous Surgery Course, Durham, NC, April 21 to 22, 2017.

None of the authors has any financial/conflicting interests to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.retinajournal.com).

Alcon speaker fees, consultant, Allergan speaker fees.

© 2018 by Ophthalmic Communications Society, Inc.