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Why might surgery not help a full-blown macular hole?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

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?

Hello,

Welcome to icliniq.com.

I read your query and understand your concern. There are two surgical outcomes of macular hole surgery. First is anatomical correction, that is, whether the gap (hole) that has formed will be filled again or not. Usually, it has a 90 % chance in a macular hole surgery. The other is functional correction, that is, how many functional retinal cells remain there, or who again takes part in bridging that hole? This functional correction depends on the timing of the surgery, that is, how old the hole is. The older the hole, the poor its recovery. Also, it depends on the grade of the hole. More the grade, the poorer the recovery. Your hole is old and, as you said, full-blown (which I am assuming is grade 4), and also, there is a concomitant Best disease that primarily affects the retina and macula. So, combining all these factors makes surgery a less likely intervention. I hope that answers your query. Thank you.

Medically reviewed byDr. K. Shobana

Published At January 25, 2018
Reviewed AtJune 6, 2025

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Rahul Vaswani
Dr. Rahul Vaswani

Ophthalmology (Eye Care)

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