Vitrectomy techniques for complex retinal detachments

Complex retinal detachment includes proliferative vitreoretinopathy, traction retinal detachment, giant retinal breaks, and a subset of retinal detachments associated with trauma. These situations present a particular challenge to retinal reattachment procedures. Specific intraoperative and postoperative vitreoretinal techniques may facilitate effective repair of complex cases. The author present a review of vitrectomy techniques, microsurgical instrumentation, and postoperative management with intravitreal tamponade agents. Many techniques and tools are required to repair complex retinal detachments; a vitreoretinal surgeon must master all the described techniques and utilize flexible decision-making. A 25-gauge, sutureless vitrectomy without scleral buckling is the best option for complex retinal detachments.