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OBJECTIVES To reassess the definition of a large macular hole, factors predicting hole closure and post-surgery visual recovery. DESIGN Database study of 1483 primary macular hole operations. Eligible operations were primary MH operations treated with a vitrectomy and a gas or air tamponade. Excluded were eyes with a history of retinal detachment, high myopia, previous vitrectomy or trauma. RESULTS A higher proportion of operations were performed in eyes from females (71.1%) who were 'on average' younger (p less then 0.001), with slightl