方法：回顾性研究2017-07/2020-06于遵义市第一人民医院就诊的特发性黄斑裂孔患者22例22眼的临床资料，根据手术方式将其分为内界膜剥除组8例8眼和内界膜翻转覆盖组14例14眼，分析两组患者术前及治疗后1wk，1、3mo的非接触眼压、最佳矫正视力(BCVA)、黄斑OCT检查等指标。

结果：内界膜剥除组黄斑裂孔愈合率为75%，改良内界膜翻转覆盖组裂孔愈合率为93%，两组之间无差异(P=0.527)。两组患者术后BCVA的变化趋势相似，在时间上有差异(F_时间=18.426，P_时间<0.001)，但组间及交互无差异(F_组间=1.319，P_组间=0.289； F_{组间×时间}=1.658，P_{组间×时间}=0.211)。两组患者术后1wk BCVA较术前差异均有统计学意义(t=-2.200、-3.092，均P<0.05)； 内界膜翻转覆盖组术后3mo BCVA较术前视力提高(t=2.503，P=0.019)。两组患者术后黄斑中心凹厚度总体比较无差异(F_时间=1.054，P_时间=0.346； F_组间=0.110，P_组间=0.750； F_{组间×时间}=2.391，P_{组间×时间}=0.152)。

结论：两种黄斑内界膜剥除方式均能有效提高黄斑裂孔闭合率，改良内界膜翻转覆盖术后黄斑结构愈合形态较好，术后视功能提升较为满意。

METHODS: A retrospective analysis of the clinical data of 22 patients with macular hole, who received vitrectomy in the First People's Hospital of Zunyi City from June 2017 to June 2020. According to the surgical methods, they were divided into 8 cases and 8 eyes in the ILM peeling group and 14 cases and 14 eyes in the ILM inversion covering group. The two groups of patients underwent best corrected visual acuity(BCVA)test, non-contact intraocular pressure and optical coherence tomography(OCT)examination before and 1wk, 1, and 3mo after operation were analysed.

RESULTS: The macular hole closure rate in the ILM peeling group was 75%, and the hole closure rate in the ILM inversion and insertion group was 93%. There was no statistically significant difference in the hole closure rate between the two groups(P=0.527). The trends of BCVA over time in the two groups were similar, but there were differences in time(F_time=18.426, P_time<0.001)and no difference between groups and interactions(F_{between groups}=1.319, P_{between groups}=0.289; F_{between groups×time}=1.658, P_{between groups×time}=0.211). The BCVA of the two groups was statistically significant 1wk after operation compared with that before operation(t= -2.200, -3.092; all P<0.05); The BCVA of the ILM inversion and insertion group was improved 3mo after operation compared with that before operation, and the difference in the group was statistically significant(t=2.503, P=0.019). There was no difference in overall foveal thickness between the two groups after surgery(F_time=1.054, P_time=0.346; F_{between groups}=0.110, P_{between groups}=0.750; F_{between groups×time}=2.391, P_{between groups×time}=0.152).

CONCLUSION: Both ILM inversion and insertion and ILM peeling can effectively increase the rate of macular hole closure. The macular structure healing after the ILM inversion and insertion is better, and the postoperative visual function improvement is more satisfactory.