Complications are a harsh reality for surgeons. No matter how honed our surgical skills, what tools are at our disposal, or how meticulous our surgical planning, we all inevitably face cases that do not go as intended. These are the surgeries that test us, keep us awake at night, and push us to navigate and overcome challenges in order to achieve successful outcomes.

In this issue of ME, eight surgeons show complex cases they have encountered and share their strategies for management. Inside is a range of nerve-wracking scenarios: pseudoexfoliation, lenticular coloboma, the Argentinian Flag sign, hypermature cataracts, and more. I’m shuddering as I write this. As you watch these videos, take particular note of the surgeons’ plans and pivots, and store them in the back of your mind. They will be useful when—not if—you end up in a similar challenging scenario.

—Christopher E. Starr, MD