Macular Hole


Macular hole is a serious pathology affecting the macula, i.e. the central part of the retina responsible for a detailed color vision, and can be initially associated to a circumscribed lifting of the sensorineural retina.

Several conditions exist that can cause a macular hole: vitreomacular traction (VMT), shortsightedness, proliferative diabetic retinopathy (PDR), post-surgery macular edema, persistent intraocular inflammations, etc. In many of these conditions, the formation of the macular hole is caused by a persistent traction force exerted on the macula.


After diagnosing and quantitatively evaluating a macular hole by OCT, this must be timely treated through a pars plana vitrectomy, with the removal of the vitreous and of the epiretinal membranes, including the internal limiting membrane of the retina (ILM), with the aim of restoring central vision or at least safeguarding the residual vision.

After vitrectomy, the eye progressively recovers the lost vision. The extent of the recovery depends on the size of the macular hole and the time elapsed between its formation and the surgery. Due to this reason, it is of fundamental importance that the treatment for macular hole be as timely as possible.

At the end of the vitrectomy surgery, a gas is used to fill the hole. The gas bubble must remain in contact with the macula as long as possible, since this enables the closing of the hole. The head of the patient must be held in a “face-down” position, hence the chin must be positioned as close to the torso as possible.

This after-surgery positioning, which the patient must hold for at least 3-4 days duration and for the highest number of hours daily, is fundamental for the success of 0the surgery. This position is of paramount importance for the success of the surgery, since it causes the gas to exhert the necessary pressure on the retina for repositioning it in its physiological position, making its healing easier.

The surgical success is often directly proportional to the maintenance of the after-surgery face-down positioning.


If you believe that you are suffering from this pathology or you have any doubts that you wish to be clarified you can contact us.


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