Macular hole

Initially, your vision after surgery will worsen due to the gas bubble used to help close the macular hole. However, longer-term, most people experience an improvement in their vision. Success varies, depending on how long you've had the macular hole before surgery.

The operation is successful for nine in ten people who've had a macular hole for six months or less.

The success rate drops to six in ten for people who've had their macular hole for a year or longer.

Even if the surgery doesn't improve your vision, it's likely to prevent it from getting worse. If a macular hole does not close after vitrectomy, a second operation may be an option and can still be successful.

Immediately after surgery, you'll experience poor vision due to the temporary gas bubble in your eye. This could affect how you judge distances and your balance, so you'll need to take care and won't be able to drive yourself home after surgery.

Within two to three weeks, you'll start to see an improvement as the natural fluid returns to your eye. It takes a few months for the retina to heal, and as it does, your vision should continue to improve. The final result can depend on the size of macular hole and how long you had it before surgery.

Generally, vitrectomy surgery is effective, but there can sometimes be complications.

If the macular hole doesn't close after surgery, you may need to have the operation again.

It's very common to develop a cataract in the affected eye after surgery, which can be treated with cataract surgery. Cataract surgery may be carried out at the same time as the vitrectomy.

Other rare complications can include retinal detachment, infection, bleeding in the eye, and high pressure in the eye, which can damage the optic nerve, but is generally manageable with medication.

For a couple of weeks after surgery, you'll be given eye drops and will need to avoid certain things such as using eye make-up, swimming, rubbing your eyes, and intensive exercise.

Occasionally, you may be advised to do face-down positioning for a few days or weeks after surgery. This is where you hold your head still in a face-down position, also known as posturing. Doing this helps ensure the gas bubble is pressing against the macular hole, which will help it to close. You can lie or sit in this position. Your doctor will give you information and advice about this.

You shouldn't fly or be at a high altitude after vitrectomy surgery for as long as the gas bubble is still present in your eye. This is because the gas can expand, increasing pressure in the eye which can lead to vision loss. If you need any other surgery while recovering from a vitrectomy, tell the anaesthetist about the gas bubble because it can be affected by some anaesthetics.

You may be offered an alternative treatment to vitrectomy surgery if your macular hole has developed due to vitreomacular traction and if the macular hole is still at an early stage. An injection of an enzyme (ocriplasmin) can encourage the gel in the eye to come away from the macula, letting the gap close.