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Abstract
Macular holes are now a treatable condition. In the 21 years since the concept of macular hole surgery was introduced at the American Academy of Ophthalmology meeting in New Orleans, and the presenter (Neil Kelly) was laughed off the stage, the technique has progressed to the point that the authors have heard busy surgeons stand up in meetings and say ‘I have not had a failure in 3 years’. Everything can be improved upon, and macular hole surgery can be refined as the authors are sure many of those reading this review will do.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.
No writing assistance was utilized in the production of this manuscript.
Key issues:
Just over 25 years ago, macular hole was a disease which was previously inoperable.
Kelly is the father of macular hole surgery and persisted in his efforts to find a cure in spite of negative feedback from professional colleagues.
Posterior hyaloid removal during vitrectomy surgery is essential for successful macular hole closure.
Internal limiting membranes removal during surgery improves outcomes.
Indocyanine green and brilliant blue can improve surgical success rates.
Face-down positioning improves surgical success rates, but may not be necessary in the hands of some surgeons.
Macular holes can be closed in the vast majority of patients.