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

## TL;DR

A man's macular hole spontaneously closed 36 months after initial surgery, leading to improved vision over time.

## Contribution

Reports a rare case of delayed spontaneous macular hole closure after vitrectomy.

## Key findings

- Macular hole closed spontaneously 36 months after initial surgery.
- Visual acuity improved to 20/25 over 22 months post-closure.
- Ellipsoid zone gap decreased over time.

## Abstract

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 fullthickness 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.