Spontaneous closure of an idiopathic macular hole 9 months after unsuccessful vitreoretinal surgery

To report spontaneous closure of a persistent idiopathic macular hole (MH) 9 months after cataract and vitreoretinal surgery, and subsequent gas reinjection.

Baseline and follow-up examinations after surgery included slit-lamp biomicroscopy, best-corrected distance visual acuity and near visual acuity, spectral domain optical coherence tomography, and microperimetry.

Spectral domain optical coherence tomography scans showed a persistent MH after surgery until 5 months of follow-up, with an increasing base diameter of the MH and decreasing best-corrected visual acuity. Nine months after surgery, spontaneous closure of the MH with an improvement in best-corrected visual acuity was observed. These findings remained stable at 15 months of follow-up, with an additional increase in retinal sensitivity.

Spontaneous closure of a persistent Stage 3 full-thickness MH after primary surgery is possible. We recommend follow-up examinations including spectral domain optical coherence tomography for several months before scheduling a reoperation.