To investigate the features of the macular microcirculation using optical coherence tomography angiography (OCTA) in surgically closed idiopathic full-thickness macular hole (IFTMH) and the correlated independent prognostic factors for postoperative macular microcirculation remodeling.Twenty-seven eyes of 27 patients after successful IFTMH surgery that were followed for 6 months and 27 eyes of 27 age- and gender-matched healthy subjects were included. Patients with IFTMH and healthy subjects were examined using OCTA. Macular vessel density (VD), foveal avascular zone (FAZ) area of superficial capillary plexus (SCP), and flow area of outer retina and choroid were analyzed. Best-corrected visual acuity (BCVA) was evaluated before and 6 months after the surgery.The BCVA improved in eyes with IFTMH after the surgery (p < 0.001). Postoperative VD was significantly lower in eyes with IFHMH compared with the normal control eyes (p < 0.001). The mean flow area of the outer retina in eyes that underwent IFTMH surgery was significantly larger than normal control eyes (p < 0.05), while the mean flow area of choroid capillary in postoperative IFTMH was significantly lower (p < 0.01). Foveal VD was negatively correlated with both minimal and basal diameters (r = -0.473, p < 0.05; r = -0.504, p < 0.01). FAZ area was significantly positively correlated with both minimal and basal diameters (r = 0.635, p < 0.001; r = 0.606, p < 0.01). Additionally, the age of IFTMH was negatively correlated with the postoperative whole VD (r = -0.440, p < 0.05) and positively correlated with the FAZ area (r = 0.382, p < 0.05).Macular capillary plexuses observed by OCTA in eyes after IFTMH surgery had different characteristics compared to normal control eyes. Preoperative IFTMH characteristics can serve as prognostic factors for postoperative macular microcirculation remodeling.Copyright © 2025. Published by Elsevier B.V.