We describe two cases of a macular hole (MH) which had divergent manifestations and clinical courses following implantation of an Implantable Collamer Lens (ICL) in two high myopic patients. The onset of symptoms and shape of the holes, which were observed by optical coherence tomography and fundoscopy, and prognosis of the visual acuity after the surgery of each patient, were quite different. In the first patient, the symptom was an acute onset. Fundoscopy showed a cuneiform-shaped hole with internal limiting membrane defect around the hole. The prognosis after the surgery was very poor, and the best corrected visual acuity was 0.08 after complete anatomical closure. In another patient, the MH showed insidious progression with disease-free interval from ICL implantation to MH onset. After the surgery, the best corrected visual acuity was recovered to 1.0.