Updates on surgical and nonsurgical innovations for macular hole treatment

We explore the evolving landscape of macular hole (MH) management, highlighting key advancements in surgical and nonsurgical treatments. While pars plana vitrectomy with internal limiting membrane (ILM) peeling remains the gold standard for MH less than 500 μm in width and in chronic or highly myopic cases, novel techniques have expanded treatment options, including ILM flap approaches, biomaterial grafts, and regenerative therapies. Additionally, emerging nonsurgical modalities, such as pharmacological agents and stem cell-based therapies, present promising alternatives. We synthesize the current evidence in MH management, focusing on clinical implications and limitations of each technique. Furthermore, we discuss future directions to optimize anatomical and functional outcomes of complex and refractory MHs.