Purpose To explore a measuring method for retinal sensitivity in macular hole area by Microperimeter-3 (MP-3) and evaluate its predictive value on visual prognosis. Methods This was a case series study including 44 eyes of 44 patients with idiopathic macular hole. Retinal sensitivity inside and 0.5 degree outside the macular hole margin was measured, and its mean value was defined as macular hole sensitivity (MHS). Best-corrected visual acuity (BCVA), minimum diameter of macular hole (MD), IS/OS defect diameter, retinal sensitivity in 8 degrees and 2 degrees were also recorded preoperatively and 4 months after operation. Results All macular holes were closed after surgery. BCVA was significantly improved from 1.06 +/- 0.39 at baseline to 0.31 +/- 0.24 at 4 months postoperatively (P < 0.001). Meanwhile, MHS was also significantly improved from 12.02 +/- 3.74 dB at baseline to 20.72 +/- 4.00 dB at 4 months postoperatively (P < 0.001). MD, preoperative IS/OS defect diameter, preoperative BCVA, preoperative retinal sensitivity in 8 degrees and 2 degrees, and preoperative MHS were all correlated with postoperative BCVA at 4 months, but only preoperative MHS showed liner relationships to postoperative BCVA at 4 months by multivariate stepwise linear analysis. Conclusions Macular hole sensitivity by MP-3 could reflect the change of central retinal function after successful macular hole surgery. Compared to preoperative retinal sensitivity in 8 degrees and 2 degrees, preoperative macular hole sensitivity is a better predictor for visual prognosis.