Recurrent spontaneous closure of a full-thickness macular hole following IOL scleral fixation: A case report

To report a rare case of a full-thickness macular hole (FTMH) that underwent spontaneous closure on two separate occasions following vitrectomy and intraocular lens (IOL) scleral fixation.

A 58-year-old man, who had undergone IOL scleral fixation and vitrectomy for a dislocated IOL, developed an FTMH (minimum diameter: 21 μm) in the left eye approximately one year post-surgery. While awaiting surgical intervention, the macular hole closed spontaneously two months after its discovery. Two years and nine months later, the FTMH recurred (minimum diameter: 180 μm) and closed spontaneously again within four weeks. Optical coherence tomography (OCT) confirmed the presence of epiretinal proliferation (EP) at the macular surface during both occurrences.

Small-diameter FTMHs that form after vitrectomy, particularly those with associated EP, may have the potential for spontaneous closure. This case indicates that short-term observation may be a reasonable management option for select cases of small post-vitrectomy macular holes before proceeding with further surgery.