A specially designed cannulated extrusion needle facilitates the internal drainage of subretinal fluid during vitreoretinal microsurgery. Case histories demonstrate the use of this instrument in the management of complex retinal detachments including eyes with preretinal and subretinal hemorrhage, proliferative vitreoretinopathy with open peripheral retinal breaks, retinal detachment with giant retinal tear, and combined traction-rhegmatogenous detachments due to diabetic retinopathy. This method of internal drainage appears to have specific advantages over standard techniques by allowing the removal of subretinal hemorrhage, the utilization of pre-existing peripheral breaks for internal drainage, and the complete reattachment of shallow posterior pole retinal detachments to allow laser endophotocoagulation.