Full-thickness Macular Hole Formation and Spontaneous Closure Following Vitrectomy Surgery: A Case Report and Review of the Literature

Purpose: To report two cases of macular holes (MHs) that spontaneously formed and closed following pars plana vitrectomy (PPV) and summarize the literature. Case Report: A 72-year-old man and a 67-year-old woman underwent PPV for repair of rhegmatogenous retinal detachment. Both patients developed MHs following PPV. In both cases, the holes closed without further surgical intervention. A retrospective chart review and literature review were conducted to supplement this study. Conclusion: Spontaneous MH closure is possible in post-vitrectomized eyes. Small- or mediumsized MHs (<400 μm) may be more likely to close spontaneously. Large MHs (>400 μm) that form in the setting of vitreomacular traction (VMT) from residual posterior vitreous cortex remnants were found to close after spontaneous VMT release, often within the first month following surgery. Overall, among eyes with spontaneous closure, about two-thirds of MHs in the literature closed spontaneously within the first month following diagnosis, and 4 in 5 holes closed within 3 months. Over one-third of MHs that close spontaneously reopen later, some requiring additional surgery to achieve closure. Sustained closure was seen in this report up to 7 years following closure.