Surgical repair of full-thickness idiopathic macular holes associated with significant macular drusen

To evaluate the visual and anatomic results of surgically repaired macular holes in eyes with intermediate or large-sized macular drusen. Retrospective noncomparative case series. Thirty-four eyes of 32 patients undergoing macular hole surgery with preoperative intermediate or large-sized macular drusen as defined by the Age-Related Eye Disease Study (AREDS). Pars plana vitrectomy for standard macular hole repair performed by multiple surgeons. Visual acuity, anatomic hole closure. Initial hole closure failed in 8 eyes (24%) overall, 5 of 28 eyes (18%) with AREDS category 2 drusen and 3 of 6 eyes (50%) with category 3 drusen ( P = 0.1263). Final macular hole closure was seen in 93% of category 2 and 67% of category 3 eyes ( P = 0.1347). Mean final visual acuity was 20/60 overall, 20/60 for category 2, and 20/50 for category 3 eyes. A trend of reduced initial macular hole closure was seen in eyes with significant macular drusen. Reoperation improved closure rates. If closure was accomplished, visual outcomes were excellent.