Abstract

To produce a flat retina after an operation demands an unrestricted view of the retina during the operation, and to achieve such a view most retinal surgeons would unhesitatingly recommend the binocular indirect ophthalmoscope and scleral depression. Once the retina and all its breaks are clearly in view, the keynote of the ensuing surgery should be simplicity and safety. The former requires that the intended operation should be the least complicated available, and, should the surgical intention be frustrated, that each step should blend with the next in orderly progression, the surgeon exhausting the possibility of one step before moving on to the next and being able to recognise when the possibilities are exhausted. The latter requires experience in deciding which is in fact the least complicated operation. In general the cavity of the globe should not be entered unless the eye stands to lose more than it gains by remaining inviolate. Paracentesis, fluid release, and intravitreal air all have their place, and to avoid them gains us nothing if the retina remains detached.