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Macular Hole Surgery

The retina is that part of the eye that converts images from the eye’s optical system into electrical impulses that are sent along the optic nerve for transmission to the brain. It forms a thin membranous lining that lies against the back surface of the eye wall. The macula is the very small, central part of the retina that provides the crisp, sharp images for activities such as reading. It is a highly specialized area of the retina that is capable of the detailed vision needed for seeing fine detail and central vision.

Mac Hole OCTA macular hole is a break in the macula. It is a disorder that most often occurs with aging, but may be the result of eye diseases, disorders or injury. The central portion of the eye is filled with a jelly-like substance known as the vitreous. With aging, the vitreous shrinks and tugs as it moves away from the retina. The vitreous may pull away without any negative effects, but it may pull on the retina as it withdraws from the retina and form a hole. The liquid may then permeate through the hole and cause a separation of the retina centrally. The result is a distortion or loss of central vision.

A surgical procedure called vitrectomy offers hope for visual improvement. In vitrectomy, the vitreous gel within the center of the eye is removed, releasing the pulling on the retina that caused the macular hole. Then a large bubble of gas is placed in the eye that replaces the vitreous and presses the retina and macula back up against the wall of the eye. As the retina remains in contact with the gas bubble, it seals the macular hole. In order for the hole to heal, the gas bubble must maintain continuous contact with the area of the macula, so the patient’s head must remain in a face-down position to allow the gas bubble to rise up to the back of the eye and maintain contact with the hole.

The patient must maintain this very important facedown position about ninety percent of the time for about one to two weeks for the surgery to be successful. Full healing may take several months. The patient will most likely use certain eye drops during the course of healing.