One-Year Outcome of Vitreous Cortex Remnants Removal Using a Nitinol Flex Loop for Recurrent Retinal Detachment Patients.

Abstract

Purpose: To evaluate the 1-year outcome of vitreous cortex remnants (VCRs) removal using a nitinol flex loop during pars plana vitrectomy (PPV) in the treatment of recurrent retinal detachment (rRD).

Patients and methods: A total of 95 eyes from 95 patients with rRD with the intraoperative evidence of VCRs were retrospectively analyzed at the First Affiliated Hospital of Nanjing Medical University. Vitreous visualization was enhanced with triamcinolone. The presence of VCRs was determined by gently scraping the retinal surface with a disposable nitinol loop. Patients were divided into two groups: conventional PPV with the aid of vitrectomy probe and intraocular forceps between January 2022 and December 2022 (Group A, 41 eyes), and PPV assisted by the FINESSE Flex loop for VCRs removal between January 2023 and December 2023 (Group B, 54 eyes). Outcomes were assessed during follow-ups at postoperative 1 week, 1 month, 3 months, 6 months, and 12 months. Primary outcomes included vitrectomy duration, single-surgery anatomic success rate, intraoperative and postoperative complications, and best-corrected visual acuity (BCVA).

Results: Group B had a significantly shorter vitrectomy duration compared to Group A (p < 0.001). The incidence of intraoperative iatrogenic retinal breaks was significantly lower in Group B (3.7%) than in Group A (22.0%) (p = 0.015). Other intraoperative complications, including focal retinal hemorrhage and inadvertent lens touch, were comparable between groups (all p > 0.05). No cases of iatrogenic rhegmatogenous RD or vitreous hemorrhage were observed in either group. The single-surgery anatomic success rate was higher in Group B (98.1%) than in Group A (85.4%) (p = 0.049). No significant differences were found in the total number of RD surgeries or final BCVA between groups (p = 0.076 and p = 0.109, respectively). During the follow-up, unattached retinas occurred in 6 eyes in Group A and 1 eye in Group B; ocular hypertension was noted in 2 eyes in Group A and 3 in Group B.

Conclusion: Use of the FINESSE Flex loop during PPV for rRD allows a shorter surgical duration, a lower incidence of iatrogenic retinal breaks, and a higher single-surgery anatomic success rate, without increasing postoperative complications.