Most full-thickness macular holes will require surgical treatment. Surgery for macular holes involves a vitrectomy, a form of "keyhole" surgery that uses small instruments to enter the eye to remove the vitreous gel. In most cases, the innermost thin layer of the retina is peeled off, to relieve stress on the macula and to allow the hole to close. Usually, a gas bubble is injected into the eye at the end of surgery, to replace the vitreous gel, and to maximise the chances of success.
The rates of surgical success and improvement in vision vary from person to person and ranges from 60% to 80%. The likelihood of hole closure and the amount of vision improvement depend on the size of the hole, and how long the symptoms and hole have been there for, prior to surgery.
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