AIM: To choose the filler for the treatment of idiopathic macular hole(IMH).

METHODS: Clinical data of 46 eyes of 46 cases with IMH who underwent surgical treatment were retrospectively analyzed. Patients in Group A(23 eyes)underwent pars plana vitrectomy + membrane peeling + Silicone oil injection and patients in Group B(23 eyes)underwent pars plana vitrectomy + membrane peeling + C2F6(20%)gas liquid injection. EDI-OCT was used to measure the subfoveal choroidal thickness(SFCT)before the surgery. Changes in best corrected visual acuity(BCVA), the closure rate of hole, the damage diameter of IS/OS and the complications after the surgery were observed.

RESULTS: The follow-up time was 12mo at least. In Group A, the post-operative BCVA improved compared with preoperative one and the difference was statistically significant(t=7.659, P<0.05). In Group B, the post-operative BCVA improved compared with preoperative one and the difference was statistically significant(t=11.648, P<0.05). In Group A, the closure rate of hole is 100%. In Group B, the closure rate of hole is 95.2%. In Group A, the post-operative damage diameter of IS/OS improved compared with preoperative one and the difference was statistically significant(t=12.252, P<0.05). In group B, the post-operative damage diameter of IS/OS improved compared with preoperative one and the difference was statistically significant(t=13.257, P<0.05). Complications: In Group A, high intraocular pressure occurred in 4 eye after the surgery. In group B, retinal detachment with the hole not closed occurred in 1 eye, and the hole was closed after the silicone oil injection again. In Group B, vitreous hemorrhage occurred in 2 eyes after surgery, one eye was absorbed naturally, and one eye needed surgery again.

CONCLUSION: The two kinds of operation can cure IMH effectively. The surgical method of Group A can press the retina persistently, increase the chance of the macular hole closing. But patients needed lie prone for a long time, and needed surgery again to get the silicone oil out, increase the burden of the patients. The surgical method of Group B needn't surgery again to get the fillers out, but needed surgery again when the macular hole fails to close. We used the SFCT as the guidelines to design the surgical method. We provided personalized treatment for patients.