Spontaneous closure of a macular hole in an unusually long time after primary vitrectomy

We report the case of a 68-year-old man who presented to our outpatient clinic for routine examination. Fifteen months before, he had undergone combined cataract and idiopathic full-thickness macular hole surgery in his right eye at another institution. In the present evaluation, the best-corrected visual acuity in his right eye was counting fingers. Fundus examination evidenced an idiopathic full-thickness macular hole in that eye, which was confirmed on spectral domain optical coherence tomography. A new surgery was offered, but the patient declined. Twenty-one months after his first consultation with us (36 months after the surgery), spectral domain optical coherence tomography revealed spontaneous closure of the idiopathic full-thickness macular hole, with a gap at the foveal ellipsoid zone. At the final visit, 22 months after the closure of the idiopathic full-thickness macular hole, the patient's best-corrected visual acuity was 20/25, and the gap at the ellipsoid zone had decreased.