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To determine the size of the superficial foveal avascular zone (FAZ) by optical coherence tomography angiography before and after surgery for an idiopathic macular hole.A retrospective, observational case series, in which 16 eyes of 16 patients with an idiopathic macular hole were studied. Pars plana vitrectomy was performed with internal limiting membrane peeling. The foveal retinal vasculature was examined by optical coherence tomography angiography, and the area of the superficial FAZ was determined before, and at 1 and 3 months after the surgery. The area of the macular hole was also measured in the en face optical coherence tomography images. The central foveal thickness was measured to determine the relationship between the size of the superficial FAZ and foveal shape. The unaffected fellow eyes were used as controls.The mean age of the patients was 68.9 years. The average preoperative superficial FAZ area was 0.45 ± 0.14 mm2, which was significantly reduced to 0.23 ± 0.08 mm2 at 1 month (P < 0.001) and 0.25 ± 0.08 mm2 at 3 months postoperatively (P < 0.001). The size was smaller than that of the control eyes (0.36 ± 0.12 mm2, P = 0.003). There was a significant inverse correlation between the area of the postoperative superficial FAZ and the central foveal thickness (r = −0.589, P = 0.016). The correlations between the visual acuity and the area of the superficial FAZ at 1 and 3 months postoperatively were not significant (P = 0.369 and 0.285).The significant decrease in the superficial FAZ after the macular hole surgery indicates that there was a centripetal movement of the foveal tissue postoperatively.