A surgical procedure called vitrectomy is often used to treat holes that go all the way through the macula. The vitreous is removed to prevent it from pulling on the retina. It is replaced with a gas bubble that eventually fills with natural fluids. Following surgery, patients must usually keep their faces down for two or three weeks. This position allows the bubble to press against the macula and seal the hole.
Vitrectomy can lead to complications, most commonly an increase in how fast cataracts develop.
Other less common complications include infection and retinal detachment either during surgery or afterward. The surgery is about 90 percent effective in closing the hole. However, improvement in people's vision is more variable. More than half of those who have the surgery can expect an improvement of two lines or more on the vision chart. Very few people get a macular hole in the second eye.