Introduction: this study evaluates the impact of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) peeling and platelet-rich plasma (PRP) application on anatomical, functional, and quality-of-life (QoL) outcomes in patients with macular holes.Method: prospective cohort study. Tertiary eye care center, January 2021 to December 2023. A total of 155 patients underwent PPV with ILM peeling and PRP. Visual acuity (logMAR), macular hole closure, and QoL were assessed pre- and postoperatively. QoL evaluation used a localized adaptation of the NEI VFQ-25 questionnaire. Anatomical outcomes were measured by Optical Coherence Tomography (OCT).Results: the mean age was 65,90 ± 8,84 years; 38 % were female. The closure rate was 94 %. Visual acuity improved significantly, with average logMAR improving from 0,7 to 0,3 (p < 0,001). QoL scores improved across all domains: visual functioning increased from 55.3 to 85.7, daily activities from 48,2 to 80,4, and psychological well-being from 50,1 to 82,9. Patients reported greater independence and improved ability in activities like reading, recognizing faces, and participating in sports.Conclusion: PPV with ILM peeling and PRP is highly effective for macular holes, yielding strong anatomical and functional outcomes alongside significant QoL enhancements
