Vitrectomy surgery is the most effective treatment to repair a macular hole and possibly improve vision.
Macular hole surgery involves using tiny instruments to remove the vitreous gel that is pulling on the macula. The eye is then filled with a special gas or oil bubble to help flatten the macular hole and hold the retinal tissue in place while it heals.
If you have vitrectomy surgery, you must maintain a constant face-down position after surgery to keep the bubble in contact with the macula to allow effective healing. This can range from a few days to a few weeks, depending on your surgeon’s recommendation and the size of your hole. A successful result often depends on how well this position is maintained. The bubble will then slowly dissolve on its own, or, in some cases, be removed by your Eye M.D.
If you have a gas bubble, you cannot fly in an airplane until the gas bubble has dissolved, as a rapid increase in altitude can cause a dangerous rise in eye pressure. You must also not undergo general anesthesia using nitrous gas, though it is generally safe to have general anesthesia without using nitrous gas.
As the macular hole closes, the eye usually regains some of the lost sight. How much vision is restored generally depends on the size of the hole and how long it was present before surgery.