Pars plana vitrectomy has provided an approach to those situations in which treatment of a retinal detachment becomes impossible due to vitreous pathology. The records of the first 207 pars plana vitrectomies performed by one of us (M.S.) were reviewed and attention was focused on the combined vitrectomy-scleral buckle procedures, particularly with regard to anatomical reattachment and visual improvement. This group was then divided into those in which a one-handed technique was used (29 procedures on twenty-eight eyes, involving 27 patients) and those in which a two-handed technique was used (22 procedures on twenty-two eyes of twenty-two patients). A combined vitrectomy scleral buckle approach has succeeded in reattaching the retina in a number of cases and provided a number of patients with worthwhile visual improvement.