The retina layer of the eye is a layer of nerve cells that notices the light coming from outside and transmits it to the brain. If we compare the eye to a camera, the retina is the film strip inside the camera. The macula region is located in the middle of this layer. In the middle of the macula region is the fovea region, in which the light is focused on. The "yellow spot" is the most important region of the retinal layer responsible for central vision and detailed vision.
The macular hole is the puncture that occurs right in the center of the visual center. In patients who develop macular hole, a black spot occurs in the center of vision and affects vision. Detailed visual functions such as choosing the faces of people and reading newspapers are highly affected. Peripheral vision is not affected because other retinal areas are normal.
The most common cause of the macular hole is a condition called idiopathic, which occurs spontaneously for no reason. Age has an effect on this. Apart from this, the traumas taken may cause macular hole. If the macular hole has occurred spontaneously in one eye, it is more likely to be seen in the other eye than healthy individuals. Although the factors leading to the macular hole are not fully known, some changes in the eye play with age. The intraocular fluid, called vitreous, shrinks over time, exerting a pulling force into the visual center and creates a hole in this area.
It is not possible to treat the macular hole with medication, a surgery called vitrectomy should be performed. In vitrectomy surgery, the vitreous fluid is cleaned, the thin membranes located in the macular region and causing reservations are peeled, then an air-like gas is injected into the eye. The patient's vision will be low for several weeks due to the gas in the eye after the operation. The patient's vision improves as the gas spontaneously withdraws and the fluid replaces it. The success rate of the operation, i.e. the probability of closing the macular hole, is around 80-90%. However, this rate of success decreases in cases of trauma, long term holes, and large diameter holes.
Macular hole surgery can be performed under local or general anesthesia. To increase the chance of the macular hole closing, patients are hospitalized in a face-down position for several days after surgery.