Based on the improved understanding of massive periretinal proliferation (MPP) as a proliferative membrane-forming disease, a new therapeutic approach is presented with the technique of pars plana vitreous surgery. Not only vitreous membranes but also preretinal membranes are removed. Forty-seven consecutive patients who suffered from severe massive periretinal proliferation were operated on with this technique and followed for six months or more. Seventeen patients (36%) had an attached retina. Twelve patients had a major visual improvement. The major postoperative complication was phthisis bulbi, found in ten eyes (21%).