Q. I am told surgery will not help my macular hole. Why?

Answered by
Dr. Rahul Vaswani
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 25, 2018

Hello doctor,

I have Best's disease and am currently undergoing injections in my left eye and it is improving. I have now been told that my right eye has a full blown macular hole but surgery may not help. Why not?

Dr. Rahul Vaswani

Ophthalmology (Eye Care)


Welcome to icliniq.com.

There are two surgical outcomes of a macular hole surgery.

Anatomical correction, that is, whether the gap (hole) that has formed will be filled again or not. Usually, it has 90 percent chances in a macular hole surgery.

Functional correction, that is, how many functional retinal cells remain there or who again take part in bridging that hole. This functional correction depends on the timing of the surgery, that is, how old is the hole. Older the hole, poor is recovery. Also, it depends on the grade of the hole. More the grade, poorer the recovery.

Your hole is old and as you said full-blown (which I am assuming grade 4), and also there is a concomitant Best disease which primarily affects retina and macula. So, combining all these factors makes surgery a less likely intervention.

For more information consult an eye care ophthalmologist online --> https://www.icliniq.com/ask-a-doctor-online/eye-care-ophthalmologist

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