To evaluate the efficacy of surgical treatment for a lamellar macular hole in highly myopic patients.

We retrospectively analyzed 31 eyes of 31 patients with a high myopia, who underwent 23-gauge vitrectomy and inner limiting membrane peeling after diagnosis of a lamellar macular hole. Thirty-two eyes of 32 patients with no high myopia were selected as the control group. The best-corrected visual acuity (BCVA) was checked and optical coherence tomography was used to evaluate structural changes in the lamellar macular hole before surgery, 6 months, 12 months, and 24 months after surgery.

The high myopia group and the control group showed statistically significant differences between preoperative BCVA and central foveal thickness. The success of primary surgery was 96.77% in the high myopia group and 100% in the control group. At postoperative 24 months, the high myopia group showed significantly poorer BCVA, and a statistically significant difference in the central foveal thickness and the inner and outer diameters of the lamellar macular hole. In cases of foveoschisis or a very high degree of myopia of more than -8.0 diopters, there was no significant improvement in BCVA after surgery.

Surgical treatment of a lamellar macular hole associated with a high degree of myopia showed excellent surgical success, but was as statistically significant as surgical treatment of non-myopia eyes. Early surgical treatment can be considered for a lamellar macular hole associated with a high degree of myopia when preoperative visual acuity and macular architecture are preserved.