Vitreoretinal surgical techniques are used to address disorders of the posterior segment of the eye. Great strides have been made in the ability to safely and effectively operate in the posterior segment over the last 20 years. With the evolution of advanced microsurgical instruments, computerized infusion and aspiration systems, endolaser probes, perfluorocarbon heavy liquid for manipulation of detached retinal tissue, implantable slow-release pharmacological devices, wide angle optical viewing systems, and long-acting gases and silicone oil for intraocular tamponade, the spectrum of disorders which are amenable to operative intervention has broadened significantly. The treatment of intraocular tumors with radioactive episcleral plaques has also become well established in recent years. However, in many cases of primary retinal detachment, the most appropriate treatment remains the standard scleral buckling operation that has been performed for over 60 years.

The scleral buckling operation consists of placing a strip of silicone around the outside of the globe to cause a slight indentation or buckle of the eye wall. The buckle achieves its purpose because the indentation helps close the causative retinal tear inside the eye. A combination of support from the buckle and chorioretinal scarring induced by treating the tear with cryotherapy maintain closure of the retinal tear. Complex retinal detachments with very large or posteriorly located retinal tears, significant retinal scarring, vitreous hemorrhage, or severe cataract formation are usually approached with a combination of scleral buckle and the more advanced intraocular vitrectomy techniques listed above.