The contribution of vitreoretinal surgery to the management of refractory glaucomas.

Vitreoretinal techniques, although not new, are only gradually being recognized in the management of refractive glaucoma. Besides rare but established indications for vitrectomy, as in malignant glaucoma, vitreoretinal surgery may become even more valuable by offering an alternative outflow route to the choroid that remains open and functional. Vitreoretinal surgery in neovascular glaucoma is primarily meant to be antivasoproliferative surgery. Vitrectomy-lensectomy accesses the eye for panretinal laser coagulation, the only effective treatment of ocular neovascularization so far. Vitrectomy is a way of interfering with the pathogenesis of ocular new vessel formation, which otherwise inevitably leads to phthisis.