AIM: To evaluate the anatomic and visual outcomes of 25-gauge vitrectomies combined with air tamponade for the treatment of idiopathic macular hole(IMH).

METHODS: Thirty eyes of 27 patients with IMH were included in this prospective interventional study. All patients underwent 25-gauge pars plana vitrectomy(PPV)combined with phacoemulsification and air tamponade. Best corrected visual acuity(BCVA, logMAR), perimetry and multifocal electroretinography(mfERG)were conducted before and after the operation. Anatomical changes were evaluated with optical coherence tomography(OCT).

RESULTS: The macular holes closed successfully in 28 eyes after the primary vitrectomy. The mean BCVA improved from 0.72±0.22 logMAR preoperatively to 0.29±0.18 logMAR postoperatively(P<0.001). In the visual field of central 10°, the average mean deviation(MD)decreased from -3.59±1.83 dB preoperatively to -2.51±1.36 dB postoperatively(P<0.001)and the average pattern standard deviation(PSD)decreased from 1.86±0.68 dB preoperatively to 1.33±0.32 dB postoperatively(P=0.001). The retinal response densities of mfERG in the foveal and perifoveal area increased significantly, and implicit times of rings 4-6 prolonged significantly(P<0.05). The symptom duration and baseline N1 amplitude densities at ring 1 had a significant impact on postoperative BCVA(P<0.001, P=0.001, respectively).

CONCLUSION: The 25-gauge PPV and air tamponade with 1 day prone positioning produce favorable anatomic and functional outcomes.