What is the treatment and how successful is it?

Vitrectomy surgery

A macular hole can often be repaired using an operation called a vitrectomy, withinner limiting membrane (ILM) peel and gas.

If you've had the hole for less than a year, there's around a 90% chance the operation will be successful in closing it. More than 70% of people successfully treated will be able toread two or three additionallineson a standard vision chart, comparedto before the operation.

Even if surgery does not achieve this degree of improvement, your vision will at least become stable, andyou mayfind you have less distortion of vision.

In a minority of patients, the hole doesn't close despite surgery, and the central vision can continue to deteriorate. However, a second operation can still be successful in closing the hole.


If a macular hole is caused by vitreomacular traction, it may be possible to treat it with an injection of ocriplasmin into the eye. The injection helps the vitreous jelly separate from the back of the eye and allows the macular hole to close. This treatment is successful at closing a macular hole in around 40% of cases.

The injection takes a few seconds and you'll be given local anaesthetic aseye drops or an injection, so you won't feel any pain. You'll alsobe giveneye drops to dilate your pupil, so the ophthalmologist can see the back of your eye.

An ocriplasmin injection is usually only available in the early stages, while the macular hole is less than 400 micrometres wide, but causing severe symptoms.

Ocriplasmin can cause some mild side effects, which usually go away,such as:

  • temporary discomfort
  • floaters
  • flashing lights
  • dimming of vision
  • yellow tinge to the vision

Asmall number of people may develop more severe side effects, such as a noticeablelossof vision, enlargement of the macular hole or retinal detachment. Surgeryisusuallyneeded to correct macular hole enlargement or retinal detachment.

You won't be able to drive after the injection, as the eye drops cause your vision to be blurry. However, you should have normal, comfortable vision the day after.

If the ocriplasmin injection fails to close the macular hole, which happens in around 60% of cases, vitrectomy surgery will be needed to close the macular hole and improve the vision.

Content supplied by the NHS Website

Medically Reviewed by a doctor on 21 Dec 2018