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The non-drainage segmental buckling procedure by Custodis for repair of a retinal detachment harboured serious postoperative complications. To amend this new technique to a minimal extraocular surgery with practically no intra- nor postoperative complications, four hurdles had to be overcome: diathermy was replaced by cryosurgery, polyviol plombe by the silicone sponge, eight rules were defined to find the break in a primary retinal detachment or in an eye up for reoperation and a subsequent 15-year follow-up of anatomical and functional results confirmed that minimal extraocular surgery for repair of retinal detachment suffices for optimal long-term results without harbouring secondary complications threatening regained visual acuity.

A 50-year review of minimal extraocular surgery for retinal detachment: five hurdles had to be overcome for its acceptance