Objective To evaluate the treatment efficacy of 25G minimally invasive vitrectomy, internal limiting membrane peeling and inert gas or air filling for idiopathic macular hole.Methods The clinical data of 29 cases ( 29 eyes) of idiopathic macular hole that were treated in our hospital between April 2013 and October 2014 were analyzed retro-spectively.Macular hole diameter were >350 μm, and stages were III to IV.A standard three port pars plana 25G mini-mally invasive vitrectomy combined with internal limiting membrane peeling was performed.Filling gases were either inert gas (5%C3F8;n =25) or air ( n =4).Patients were instructed to maintain prone position after surgery.When the gas was absorpted more than 50%, patient was examined with OCT.Results In the eyes filled with inert gas, macular hole closed completely ( n =23) or attached ( n =2;diameter was >900μm in these 2 eyes) .Visual acuity improved 2 rows or more in 76%(23/25) patients.In 4 eyes filled with air, macular hole closure was incomplete.Visual acuity did not improve and patients needed a second surgery a week later.OCT examination 2 weeks after the surgery showed complete closure in 3 eyes and attached macular hole in 1 eye ( macular hole diameter was 997μm) .Visual acuity improved 2 rows or more in 3 eyes (75%) .Conclusion Inert gas filling in the treatment of idiopathic macular hole is safer and more ef-fective than the air filling.%目的：应用25G微创玻璃体切除联合内界膜撕除治疗特发性黄斑裂孔，对比填充惰性气体与填充空气对黄斑裂孔愈合的效果。方法回顾性分析2013年4月至2014年10月在我院治疗的特发性黄斑裂孔患者29例（29只眼），黄斑裂孔直径均＞350μm，属于III-IV期黄斑裂孔。行标准三切口经睫状体平坦部25G微创玻璃体切除联合内界膜撕除术，根据填充气体的不同，分为惰性气体组（5％C3 F8）和空气组，其中惰性气体组25例（25只眼），空气组4例（4只眼），术后俯卧位，当气体吸收少于1／2后，行OCT检查，观察黄斑裂孔闭合情况。结果惰性气体组，23只眼裂孔完全闭合，2只眼黄斑裂孔贴附（裂孔直径＞900μm），视力提高2行以上者占76％（23／25）。空气填充组4例（4只眼）黄斑裂孔均未完全闭合，视力未提高，1周后再次手术，填充5％C3 F8惰性气体，2周后行OCT检查，3只眼黄斑裂孔完全闭合，1只眼黄斑孔贴附，视力提高2行以上者3只眼占75％，贴附者术前黄斑裂孔直径997μm。结论在内蒙地区惰性气体填充治疗特发性黄斑裂孔更安全，效果更好，优于空气填充。
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