To report a case of delayed idiopathic macular hole closure after vitrectomy, internal limiting membrane peeling, and gas tamponade.

A 69-year-old female complained of visual disturbance in her left eye. At presentation, her visual acuity was 20/100 in the left eye. Fundus examination and optical coherence tomography revealed a full-thickness macular hole 489 µm in diameter as well as posterior vitreous detachment. Hence, vitrectomy, concurrent cataract surgery, internal limiting membrane peeling and gas tamponade were performed. One month postoperatively, the hole remained unclosed, although decreased in size to 378 µm. At 2 months, cystoid macular edema developed and postoperatively the hole diameter decreased gradually to 311 µm, 252 µm and 156 µm at 2, 3, and 5 months, respectively. Finally, the hole was closed upon the resolution of macular edema at 9 months. However, the visual acuity of 20/100 remained unchanged.

Delayed closure of holes which may be related to cystoid macular edema, can develop after macular hole surgery.