Like pilots with flight plans and coaches with game plans, we surgeons enter each case with a surgical plan. Based on the insights gained in the preoperative examinations and patient discussions, we open the eye with a stepwise approach and a certain outcome in mind. However, we all know what they say about best-laid plans.

Having a surgical plan is essential, but it is also imperative that we recognize when and how to deviate from that plan. Most often cases proceed as anticipated, but inevitably complications will arise, and we will encounter moments when we must pivot. Although stressful, these turning points are excellent opportunities to improve our surgical skills and strengthen our adaptability.

In this issue of MillennialEYE, surgeons recount cases that began as routine but became complex. Their articles and accompanying videos are rife with pearls for a variety of scenarios, but all promote the importance of striving to remain calm and adaptable in every surgical encounter. I hope you enjoy and pick up a few tips for the next time a case does not go according to plan.