Services
Vitreoretinal Surgery
Specialist surgical management of conditions affecting the vitreous and retina, including retinal detachment, macular disease, and complex vitreous surgery.
What is Vitreoretinal Surgery?
Vitreoretinal surgery encompasses surgical procedures on the vitreous — the gel-like substance filling the eye — and the retina, the light-sensitive layer at the back of the eye. These are among the most technically demanding procedures in ophthalmology, requiring specialised training and microsurgical skill.
The primary technique used is pars plana vitrectomy (PPV), in which tiny instruments are inserted through three small incisions in the sclera (white of the eye) to remove the vitreous gel and treat the underlying retinal condition. Most vitreoretinal surgery is performed under local anaesthesia as a day procedure.
Conditions Treated
Retinal Detachment
UrgentA sight-threatening emergency in which the retina separates from the underlying retinal pigment epithelium. Requires urgent surgical repair. Treatment options include vitrectomy with gas or silicone oil tamponade, or scleral buckling. Outcomes are best when repaired promptly.
Epiretinal Membrane
A thin, fibrous membrane grows on the macular surface, causing it to wrinkle. This leads to distorted and reduced central vision. Vitrectomy with membrane peeling typically results in significant visual improvement.
Macular Hole
A full-thickness defect in the macula causes a central scotoma (blind spot) and severely reduced central vision. Vitrectomy with internal limiting membrane peeling and gas tamponade closes the hole in the majority of cases.
Vitreous Haemorrhage
Bleeding into the vitreous cavity clouds vision suddenly. Causes include diabetic retinopathy, retinal tear, or trauma. If the blood does not clear spontaneously, vitrectomy is performed to restore vision and treat the underlying cause.
Diabetic Vitreopathy & Tractional Retinal Detachment
Proliferative diabetic retinopathy can cause fibrovascular membranes that pull on the retina, causing tractional detachment. Vitrectomy removes the membranes and addresses the retinal detachment.
Complex Lens Surgery
Retained lens fragments following complicated cataract surgery, subluxated or dislocated intraocular lenses, and other complex anterior segment complications may require vitreoretinal surgical management.
About Vitrectomy
- Anaesthesia
- Local or general
- Setting
- Day surgery
- Incisions
- 3 × 0.5mm ports
- Tamponade
- Gas or silicone oil when needed
- Positioning
- Face-down may be required post-op
- Flying restriction
- No flying with gas in eye
Retinal Detachment — Act Quickly
New flashing lights, floaters, or a curtain/shadow across your vision may indicate a retinal tear or detachment. This is an emergency — please call us immediately or proceed to the nearest eye emergency department.
Urgent referrals accepted
For urgent retinal conditions, please call us directly.
Call 03 9466 8822Make an AppointmentOur Vitreoretinal Surgeon
Dr David Sousa is a fellowship-trained vitreoretinal surgeon with fellowship training in Manchester (UK) and Melbourne, currently working at the Royal Victorian Eye and Ear Hospital and Geelong Hospital. He holds a PhD and is actively involved in retinal research at the Centre for Eye Research Australia.
Dr David Sousa
MBBS FRANZCO
Vitreoretinal Surgery
Dr David Sousa graduated from the Faculty of Medicine of the University of Lisbon in 2013. He completed his Ophthalmology specialty training in Portugal, followed by Vitreoretinal fellowships in Manchester, United Kingdom and Melbourne, Australia. Dr Sousa currently works as a Vitreoretinal Surgeon in Melbourne at The Royal Victorian Eye and Ear Hospital, and in Geelong at the University Hospital and St John of God Hospital. Dr Sousa specialises in the treatment of vitreoretinal conditions including diabetic retinopathy, age-related macular degeneration, retinal detachment, epiretinal membrane, macular hole, and complex lens surgery. Dr Sousa obtained his PhD in 2021 and is currently involved in multiple research projects at Centre for Eye Research Australia, including retinal imaging biomarkers, artificial intelligence, neuroprotection and development of novel surgical devices.
Qualifications
- —MBBS
- —FRANZCO
- —PhD (Centre for Eye Research Australia)
Research
- —Multiple peer-reviewed publications in retinal imaging, artificial intelligence and neuroprotection
- —Regular speaker at international conferences
Public Appointments
- —Royal Victorian Eye and Ear Hospital
- —University Hospital Geelong
Frequently Asked Questions
What are the warning signs of a retinal detachment?
The classic symptoms of a retinal detachment are a sudden increase in floaters, new flashes of light, and a dark shadow or curtain appearing across part of your vision. These symptoms require immediate assessment — a retinal detachment is a medical emergency. Please call our rooms urgently or proceed to the nearest eye emergency department. Do not wait for a routine appointment.
Will I need to lie face-down after retinal surgery?
Face-down positioning is required after some vitreoretinal procedures — particularly macular hole surgery and certain retinal detachment repairs — when a gas bubble is used as tamponade. The bubble needs to press against the treated area of the retina to allow it to heal. The duration of face-down posturing varies from a few days to two weeks depending on the procedure. Dr Sousa will explain the specific requirements before your surgery.
Can I fly after vitreoretinal surgery?
You must not fly if you have a gas bubble in your eye. The change in cabin pressure at altitude can cause the gas to expand dangerously, leading to a sudden rise in eye pressure that can cause permanent vision loss. You will be given a card confirming you have had intraocular gas and should not fly. Flying is safe once the gas has completely absorbed — this can take 6–12 weeks depending on the type of gas used. If silicone oil was used instead of gas, flying is generally safe.
How long after surgery will my vision improve?
The timing of visual recovery depends on the condition treated and the procedure performed. After epiretinal membrane peeling or macular hole repair, vision typically improves gradually over 3–6 months as the macula heals. After retinal detachment repair, vision recovery is more variable and depends on whether the macula was involved. If the macula was attached at the time of surgery, the outlook for central vision is better.
Is vitreoretinal surgery covered by Medicare and private health insurance?
Yes. Vitreoretinal surgical procedures are Medicare-listed, and with appropriate private health insurance (hospital cover), out-of-pocket costs are substantially reduced. Emergency procedures such as retinal detachment repair are prioritised regardless of insurance status. Our team can provide a fee estimate and discuss your insurance cover prior to any planned surgery.
Refer to Our Vitreoretinal Surgeon
Dr David Sousa welcomes referrals for vitreoretinal conditions. For urgent presentations, please call us directly on 03 9466 8822.