Shovel and Cut Technique: Beveled Vitrectomy Probes to Address Diabetic Tractional Retinal Detachments

Purpose:To describe a surgical technique using the structural advantages of beveled tip cutters.Methods:The introduction of beveled tips has been one of the few modifications that have been performed to vitrectomy probes since first described by Machemer in 1972. Shovel and cut technique uses this incredible modification to access tighter planes and remove broad diabetic membranes.Description of Technique:The shovel and cut technique can be used with any gauge probe to which the bevel tip is applied. The beveled tip of the cutter is used in a shovel manner to create a tissue plane between the diabetic plaque and the retina. As the beveled tip of the cutter moves parallel to the underlying retina, scar tissue naturally feeds into the cutting port where it is cut and aspirated with low flow rates.Conclusion:Shovel and cut technique takes advantage of beveled tip technological innovation to allow easy access and tissue dissection of the most difficult plaques in diabetic membranes. This technique allows us to remove these plaques in a safer, more controlled manner than previous described techniques.