Purpose: To describe the clinical characteristics of macular holes (MH) with an intact bacillary layer.
Methods: This retrospective study analyzed the characteristics and surgical results of 23 eyes with MH and an intact bacillary layer, with or without rhegmatogenous retinal detachment (RRD).
Results: Among the 23 eyes, 11 had only MH, and 12 had concurrent fovea-off RRD. Ten eyes (43.5%) were highly myopic. In the MH-only group, no bacillary layer detachment (BALAD) was observed before MH formation. Ten eyes underwent vitrectomy with internal limiting membrane (ILM) peeling and intravitreal injection of C3F8, and the other one received an intravitreal C3F8 only. The MH closure rate was 90.9% after one operation and 100% after two. In the RRD group, 66.7% had BALAD. ILM peeling was performed in 8 eyes (66.7%). The MH closure rate was 91.7% after one operation and 100% after two. Both groups showed significant visual improvement after surgery (P < 0.05).
Conclusions: An intact bacillary layer can be observed in MH with or without concurrent fovea-off RRD. Surgical outcomes are similar to typical MH cases, and the intact bacillary layer may not facilitate MH sealing like the ILM. An ILM flap should be considered for large MHs or highly myopic eyes.