Macular hole after peeling of the internal limiting membrane in diabetic macular edema

A 61-year-old man had peeling of the internal limiting membrane using indocyanine green in combination with pars plana vitrectomy for the treatment of diffuse diabetic macular edema in the right eye. As the macular edema began to improve, a small macular hole was noticed, which progressed rapidly. After fluid-gas exchange with 10% perfluoropropane, the macular hole was closed. Caution may be needed to reduce the mechanical stress on the fovea when the internal limiting membrane is peeled in diffuse diabetic macular edema.