How is a macular hole treated?

Vitrectomy surgery is the most effective treatment to repair a macular hole and possibly improve vision.

The surgery involves using tiny instruments to remove the vitreous gel that is pulling on the macula. The eye is then filled with a special gas bubble to help flatten the macular hole and hold it in place while it heals.

You must maintain a constant face-down position after surgery to keep the gas bubble in contact with the macula. This can range from a few days to a few weeks, depending on your surgeon’s recommendation. A successful result often depends on how well this position is maintained. The bubble will then slowly dissolve on its own.

If you have a gas bubble, you cannot fly in an airplane until the gas bubble has dissolved, as a rapid increase in altitude can cause a dangerous rise in eye pressure. You must also not undergo general anesthesia using nitrous gas, though it is generally safe to have general anesthesia without using nitrous gas.

You can expect some discomfort after surgery. You will need to wear an eye patch for a short time. Your ophthalmologist will prescribe eyedrops for you and advise you when to resume normal activity.

As the macular hole closes, the eye slowly regains part of the lost sight. The outcome for vision may depend on the size of the hole and how long it was present before surgery. The amount of visual recovery can vary.

The treatment for macular hole is an operation called vitrectomy with placement of a gas bubble into the eye. This surgery fixes the macular hole in more than 90% of people and results in reading vision in about 50% of people. The longer the macular hole has been present, the worse the visual prognosis. Your surgeon will discuss with you the potential risks of the surgery.