Additional medical treatment was prescribed: 1% tropicamide 4 times daily, 1% atropine sulfate 4 times daily, and 2.5% phenylephrine hydrochloride 4 times daily. Topical and systemic aqueous suppressants were continued, but 24 hours later the anterior chamber depth and IOP were unchanged in the right eye. Neodymium:YAG laser capsulotomy was considered, but believed unlikely to be of adequate immediate benefit. The severity of the glaucomatous damage and high IOP, which prompted an urgent and effective intervention, and the presence of peripheral anterior synechiae in the anterior chamber angle, which would probably impede a satisfactory long-term control of IOP, were the factors considered in the surgical planning. The patient underwent a standard 3-port pars plana vitrectomy, removing the anterior vitreous and adhesions around the peripheral iridectomies; a Baerveldt (350 mm2) tube shunt was implanted through the pars plana. This surgical technique has been described elsewhere.5- 9 During the procedure, the anterior chamber deepened. The postoperative outcome was uncomplicated (Figure 2). Six months later, the visual acuity in the right eye was 20/80, IOP was 13 mm Hg with no medical treatment, the anterior chamber was deep, and there was no apparent complication.