Vitrectomy techniques and the use of liquid silicone oil provide important new possibilities in the management of complex retinal detachments including (1) Rhegmatogeneous detachments complicated by vitreous haemorrhages, cataract or an inadequate pupillary opening (2) Traction retinal detachment (3) Combined rhegmatogeneous-traction detachment (4) Proliferative vitreoretinopathy (PVR) (5) Giant tears, especially when the posterior flap is folded over (6) Retinal detachments with posterior retinal breaks. The current concepts in the management of the above retinal detachments are discussed and the specific techniques employed are described.