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Macular Hole
Macular holes occur right in the center of the macula. In most cases no underlying cause is found although in the younger
age-group trauma is the leading etiology. Macular holes are classified in different stages as they evolve from a small defect
in the center of the macula to a full-blown hole.
In its early stages it is possible for a macular hole to regress spontaneously. However when the hole fully opens the only
effective treatment is vitrectomy. During the operation a membrane (Internal Limiting Membrane) that surrounds the hole is
removed and a special gas (c3F8 or SF6) is placed in the eye. The gas serves as a tamponade, keeping the hole sealed as it heals.
It is important for the patient to remain face-down after the operation for at least 7-10 days. This allows the gas bubble to
prevent the hole from opening again.
Macular hole surgery is most successful when it is performed within the first 6 months of a hole opening and when the patients
vision has not dropped severely. There is a risk of the hole reopening, retinal detachment, infection, bleeding, and progression
of cataract.
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