Ab externo surgery of rhegmatogenous retinal detachment: Handling of intraoperative and postoperative complications

Retinal detachment surgery can be associated with multiple complications able to reduce the anatomic success rate and final visual acuity outcomes. Most surgical failures result from inability to detect and treat all retinal breaks, development of proliferative vitreoretinopathy, and errors in surgical judgment or technique. Complications can be divided into pre-, intraand postoperative conditions. Bad visualization and intraocular inflammation are the main preexisting factors that can complicate the surgery. Intraoperative complications are usually more serious, and can be related to anesthesia, exposure, localization and suturing of the implant, the cryopexy or drainage of subretinal fluids. The important postoperative complications are mainly related to inflammation/infection, ischemia, intraocular pressure, choroidal detachment or hemorrhage and persistent or recurrent retinal detachment. Muscle imbalance and refractive changes are common but easily treated. Buckle intrusion or extrusion can develop even years after the primary procedure.