目的：比较改良黄斑裂孔手术与传统黄斑裂孔手术治疗特发性黄斑裂孔(idiopathic macular hole，IMH)的疗效。

方法：连续选取2014-04/2017-06就诊于我院的IMH患者28例28眼，接受我院同一医师独立完成的手术治疗，分为两组。A组13例为传统玻璃体切除内界膜剥除术联合C₃F₈填充治疗组(简称传统组)，B组15例为改良吲哚菁绿染色内界膜剥除联合黄斑裂孔整复空气填充治疗组(简称改良组)。所有患者在术后1wk，1、3、6mo复查。比较两组患者术前和术后末次最佳矫正视力(best corrected visual acuity，BCVA)、手术时间、末次复查时裂孔的闭合率、俯卧时间。

结果：两组患者裂孔闭合率差异无统计学意义(P>0.05)； 两组患者术后BCVA较术前均提高，差异有统计学意义(P<0.05)，但两组间术前和术后BCVA比较差异均无统计学意义(P>0.05)； B组手术时间较A组明显缩短，差异有统计学意义(P<0.05)； B组俯卧时间较A组明显缩短，差异有统计学意义(P<0.05)。

结论：与传统组相比，改良吲哚菁绿染色内界膜剥除联合黄斑裂孔整复空气填充可以获得同样较高的裂孔闭合率，而且手术操作步骤简化，缩短了手术时间，减少器械进出切口的次数，从而减少并发症的发生。术后患者俯卧时间明显缩短，舒适度高、依从性好。

METHODS: From April 2014 to June 2017, 28 eyes of 28 IMH patients who were treated in our hospital were selected consecutively and received surgical treatment independently performed by the same physician in our hospital. The patients were divided into A(traditional group)and B(improvement group)groups. All 13 cases in Group A were treated with traditional vitrectomy internal limiting membrane peeling and C₃F₈ tamponade, while all 15 cases in Group B were treated with improved indocyanine green-assisted internal limiting membrane peeling combined with macular hole reconstruction and air tamponade. All patients were reviewed at 1wk, 1, 3, and 6mo after surgery. The best corrected visual acuity(BCVA)before and after the operation, operation time, closure rate of the macular hole during the last review and prone time were compared between the two groups of patients.

RESULTS: There was no significant difference in closure rate between the two groups(P>0.05). Postoperative BCVA increased in both groups compared with preoperatively and the differences were statistically significant(P<0.05). But there was no significant difference on BCVA between the two groups both preoperatively and postoperatively(P>0.05). The operation time in Group B was significantly shorter than that in Group A(P<0.05). Prone time in Group B was significantly shorter than that in Group A, the difference was statistically significant(P<0.05).

CONCLUSION: This study shows that compared with the traditional group, the improved indocyanine green-assisted peeling of internal limiting membrane combined with macular hole reconstruction and air tamponade can achieve similarly high closure rates while the operation procedure was simplified and the operation time was shortened. Reduced number of instruments into and out of the incision can reduce the incidence of complications. The postoperative patient's prone time is significantly shortened, with high comfort and good compliance.