OBJECTIVE To determine if fluid-fluid exchange (endo-drainage) or external needle drainage can result in retinal displacement following minimal gas vitrectomy (MGV) with no fluid-air exchange for rhegmatogenous retinal detachment (RRD) repair. METHODS Two patients with macula off RRD underwent MGV with and without segmental buckle. First case had minimal gas vitrectomy with segmental buckle (MGV-SB), along with endo-drainage, while the second case had MGV only with external fluid drainage. At the completion of surgery, the patient was immediately log rolled to face down for 6 hours followed by positioning to the break. RESULTS Both patients achieved retinal reattachment and post-operative wide-field fundus autofluorescence imaging demonstrated a low integrity retinal attachment (LIRA) with retinal displacement. CONCLUSIONS Iatrogenic fluid drainage techniques such as fluid-fluid exchange or external needle drainage during MGV (without fluid-air exchange) may result in retinal displacement. Allowing the retinal pigment epithelial pump to reabsorb the fluid naturally may reduce the risk of retinal displacement.