Surgical Retina
Advanced vitreoretinal surgery to preserve, restore and protect vision
The retina is the light-sensitive tissue lining the back of the eye. Diseases affecting the retina and vitreous can cause blurred vision, distortion, flashes and floaters, or sudden vision loss. Many of these conditions require highly specialised surgery to restore or preserve sight.
Graeme provides comprehensive vitreoretinal surgery using the latest microincisional techniques, with a focus on precision, safety, and achieving the best possible visual outcome for each patient.
Surgery is tailored to your individual condition, combining advanced technology with meticulous surgical planning to maximise both visual recovery and patient comfort.
Conditions treated with vitreoretinal surgery include:
Retinal detachment
Epiretinal membrane
Macular hole
Vitreomacular traction
Diabetic vitreous haemorrhage and tractional retinal detachment
Complications following cataract surgery, including retained lens fragments
Dislocated or subluxed intraocular lenses
Dislocated of subluxed crystalline lenses
Sub-macular haemorrhage
Symptomatic vitreous floaters
Ocular trauma
Endophthalmitis
Advanced Vitreoretinal Surgery
Graeme performs vitreoretinal surgery using the latest Alcon UNITY™ Vitreoretinal Cataract System, one of the most advanced surgical platforms available globally.
This technology combines:
Ultra high-speed 25- and 27-gauge microincisional vitrectomy
Wide-angle retinal visualisation
Advanced fluidics technology for enhanced surgical control
High-performance illumination for improved retinal visualisation
4D Phaco technology for cataract surgery, designed to significantly reduce ultrasound energy to the eye, helping to minimise post-operative inflammation
These techniologies allow vitreoretinal surgery to be performed through tiny incisions or approximately half a millimetre or less, improving precision while supporting faster recovery and greater patient comfort.
Conditions we treat
Retinal Detachment
Urgent treatment to restore and preserve vision
A retinal detachment occurs when the retina separates from the back of the eye. Without emergency treatment, permanent vision loss can occur.
Surgical repair often involves a vitrectomy, laser treatment and/or cryotherapy, with a gas bubble or silicone oil placed inside the eye, depending on the type and complexity of the detachment.
Some retinal detachments are better suited to scleral buckle surgery, where a silicone band is placed around the outside of the eye to help support the retina and close the break.
Early treatment provides the best opportunity to preserve vision and maximise visual recovery.
Epiretinal Membrane
Improving distorted or blurred vision
An epiretinal membrane is a thin layer of scar tissue that forms on the surface of the retina.
It can cause:
Blurred vision
Distorted or wavy vision
Difficulty reading
Reduced quality of vision
Vitrectomy with delicate membrane peeling can improve vision and reduce distortion in appropriately selected patients.
A macular hole is a small opening that develops in the centre of the retina.
Symptoms often include:
Blurred or missing central vision
Distortion or wavy vision
Difficulty reading
Timely vitrectomy surgery with internal membrane peeling and a temporary gas bubble allows 95% of full thickness macular holes to close successfully and improves the chance of visual recovery.
Restoring the Central Retina
Macular Hole
Sometimes the vitreous gel remains attached to the macula, causing traction that distorts central vision.
If symptoms are significant, vitrectomy surgery can relieve the traction and improve vision while helping prevent progression to a macular hole.
Releasing abnormal pulling on the retina
Vitreomacular Traction
Diabetic Vitreous Haemorrhage and Tractional Retinal Detachment
Surgery for advanced diabetic eye disease
Most diabetic eye disease is managed with laser treatment or injections.
However, surgery may become necessary when diabetes causes complications such as:
Persistent vitreous haemorrhage
Scar tissue formation
Tractional retinal detachment
Combined tractional and rhegmatogenous retinal detachment
Vitrectomy aims to remove blood and scar tissue, relieve traction, and stabilise the retina to preserve vision wherever possible.
Dislocated or Subluxed Crystalline Lenses
The natural crystalline lens in your eye can become displaced or unstable due to trauma or conditions that weaken the structures supporting the lens, including Marfan syndrome and other connective tissue disorders.
Treatment may involve:
Vitrectomy and removal of the displaced crystalline lens
Implantation of a secondary intraocular lens when appropriate
The surgical approach depends on the degree of lens displacement, the remaining lens support and the anatomy of the eye.
Restoring lens stability and vision
Complications following Cataract Surgery
Although cataract surgery is highly successful, complications occasionally occur.
As a vitreoretinal surgeon with expertise in complex cataract surgery, Graeme regularly manages referred complications including:
Retained lens fragments
Vitreous prolapse or loss
Retinal tears
Retinal detachment
Secondary intraocular lens surgery
The aim is to safely restore anatomy while maximising visual recovery.
Expert management of complex cases
An artificial lens implanted during cataract surgery can occasionally become displaced or unstable months or years later.
Treatment may involve:
Repositioning and securing the existing intraocular lens
Vitrectomy with removal or exchange of the existing lens and implantation of a secondary intraocular lens
The most appropriate approach depends on the condition of the existing lens and the anatomy of the eye.
Restoring lens stability and vision
Dislocated or Subluxed Intraocular Lenses
Symptomatic Vitreous Floaters
Treatment for persistent, visually significant floaters
Most floaters become less noticeable over time and do not require treatment.
However, some patients experience persistent floaters that significantly interfere with reading, driving, or everyday activities.
For carefully selected patients, vitrectomy can remove the vitreous gel and eliminate visually significant floaters.
The potential benefits and risks are carefully discussed before surgery, as treatment is only recommended when symptoms have a substantial impact on quality of life.
Ocular Trauma
Management of complex eye injuries
Eye injuries can affect multiple structures within the eye, including the retina, vitreous, lens, and other delicate tissues.
Graeme manages a wide range of complex ocular trauma requiring vitreoretinal surgery, including traumatic retinal detachment, intraocular foreign bodies, lens dislocation, and vitreous haemorrhage.
Treatment is tailored to the nature and severity of the injury with the aim of preserving vision whenever possible.
Submacular Haemorrhage
Treating bleeding beneath the macula
A sub macular haemorrhage occurs when blood collects beneath the central retina, most commonly due to abnormal blood vessels associated with macular degeneration. A large haemorrhage can cause sudden and severe loss of central vision.
In selected cases, early surgical treatment may help move the blood away from the centre of the macula and limit further damage due to blood toxicity to the sensitive retinal pigmented epithelium cells.
Treatment may involve:
Vitrectomy
Injection of a clot dissolving medication (tPA)
A gas bubble to help displace the blood away from the macula
Anti-VEGF injections to treat the underlying abnormal blood vessels
The most appropriate treatment depends on the size and location of the haemorrhage, its underlying cause and how long the blood has been present
Endophthalmitis is a rare but serious infection inside the eye that requires urgent specialist care.
Treatment may involve emergency vitrectomy combined with intravitreal antibiotics to control infection and preserve vision.
Prompt diagnosis and treatment are critical to achieving the best possible outcome.
Emergency treatment for severe eye infection
Endophthalmitis
What is a Vitrectomy?
A vitrectomy is the most commonly performed retinal operation.
During surgery, the vitreous gel inside the eye is carefully removed, allowing the retina to be repaired or treated using specialised microsurgical instruments.
Depending on the condition being treated, surgery may also involve:
Membrane peeling
Laser treatment
Cryotherapy
Air or gas (SF6, C2F6, C3F8) bubble placement
Perfluorocarbon Liquid (PFCL)
Silicone Oil
Sub-retinal injection
Intraocular lens repositioning or fixation
Every procedure is individually planned according to your specific eye condition.
What to expect
Your consultation includes:
A comprehensive retinal examination
OCT and retinal imaging
Discussion of treatment options
Explanation of expected recovery
A personalised surgical plan
Before Surgery
Most vitreoretinal procedures are performed under local anaesthetic, with or without sedation. General anaesthesia may occasionally be recommended.
Small (<0.5mm) incisions allow surgery to be performed with minimal disturbance to surrounding tissues.
Depending on the type of procedure and level of complexity, surgery usually takes between 30 minutes and two hours.
During Surgery
Recovery varies depending on the condition being treated.
Some patients experience rapid improvement, while others continue to recover over several weeks or months.
If a gas bubble is placed inside the eye, temporary restrictions on driving, flying and travelling to high altitude will apply until the bubble has fully resolved. These restrictions do not apply if silicone oil is used instead of gas, although silicone oil often requires a further operation for removal at a later date.
Depending on your surgery, you may also need to maintain a specific head position for a few days after surgery to support the retina while it heals.
Regular follow-up appointments allow Graeme to monitor your recovery, ensure the retina is healing appropriately and provide any additional treatment if required.
Recovery
FAQs
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Surgery is performed under anaesthetic, and most patients experience little discomfort during the procedure. Mild irritation or aching afterwards is common and usually settles over several days.
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Recovery depends on the underlying retinal condition. Some patients notice improvement within days, while others continue to improve over several months as the retina heals.
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Some retinal procedures require a temporary gas bubble to support healing. If one is used, specific postoperative instructions, including restrictions on flying, will be explained before surgery.
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Some retinal conditions can recur or affect the other eye. Ongoing monitoring helps detect any changes early and allows treatment to be provided promptly if required.
Why choose graeme?
Graeme Loh provides comprehensive medical and surgical care for retinal disease, combining expertise in vitreoretinal surgery with advanced cataract and secondary intraocular lens reconstruction.
His practice offers:
Modern microincisional vitreoretinal surgery
Advanced retinal imaging and surgical planning
The latest Alcon UNITY™ Vitreoretinal Cataract System
Expertise in complex retinal and macular disease
Combined cataract and vitreoretinal surgery
Secondary intraocular lens fixation and reconstruction
Individualised treatment plans focused on long-term visual outcomes
Every patient receives a personalised assessment, with treatment recommendations based on the nature of the retinal condition, overall eye health, and individual visual goals.
If you have been diagnosed with a retinal or macular condition, or have experienced a sudden change in your vision, early specialist assessment can make a significant difference to your outcome.
Book a consultation with Graeme to discuss your treatment options and receive expert care for retinal and vitreoretinal conditions.