Nine eyes of nine patients with rhegmatogenous retinal detachment caused by a macular hole were treated by the transvitreal application of cyanoacrylate tissue adhesive to the macular hole. Eight of the nine eyes had previously failed conventional vitreous surgery with gas tamponade and laser photocoagulation. Eight eyes (89%) were completely reattached with a minimum follow-up of three months. In the successfully treated eyes, post-operative visual acuity was 20/200 in two eyes, 20/400 to 5/200 in five eyes, and less than 5/200 in one eye. Direct sealing of macular holes in difficult cases may obviate the need for extended intraocular tamponade or macular buckling with their associated complications.