In the 25 years since the introduction of pars plana vitrectomy (PPV) into the UK, there have been dramatic changes in the surgical management of posterior segment pathology. Initially, these were largely exploratory—the new found ability to access the structures and surgical pathology of the posterior segment enabling a wide range of treatment methods previously impossible to contemplate, let alone accomplish. Control of the intraocular environment, improved delivery of internal tamponade and the design of a battery of common gauge micro instruments led rapidly to an explosion of innovative techniques.

During the past 15 years, the initial explosion has given way to a (largely) quiet revolution, with the development and refinement of established and proved methods and their direction along logical paths of treatment, in conditions which hitherto caused severe and permanent loss of sight.

The paper by Ah-Fat et al, in this issue of the BJO (p 396), reminds us that PPV offers …