OBJECTIVE This study presents a group of patients with a pseudophakic or aphakic retinal detachment (RD) and an unseen retinal break who were treated with a pars plana vitrectomy (PPV), fluid-air exchange, internal drainage, and endolaser in addition to a scleral buckle (SB) procedure. METHODS The charts of 10 consecutive patients with a pseudophakic or aphakic RD and an unseen retinal break who were treated with a PPV, fluid-air exchange, internal drainage, endolaser, and an SB were reviewed for preoperative and postoperative visual acuity, postoperative status of the retina, and surgical complications. RESULTS All of the patients with a postoperative follow-up of at least 6 months continue to maintain an attached retina after one operation. Visual acuity has improved by at least 2 lines on the Snellen chart in 7 patients, remained the same in 2 patients, and decreased in 1 patient. CONCLUSIONS This pilot study shows good anatomic results when performing a PPV, fluid-air exchange, internal drainage, and endolaser together with an SB for pseudophakic or aphakic patients with an RD and an unseen break.