目的：应用光学相干断层扫描(OCT)进行对玻璃体切割联合内界膜剥除术治疗的特发性黄斑裂孔(IMH)患者术前术后的裂孔形态观察，分析影响视力预后的因素，为有效预测术后视力提供潜在指标。

方法：选取患者32例(男7例，女25例)行玻璃体切割联合内界膜剥除，膨胀气体充填手术的IMH患者，对其均进行术前术后的OCT检查和眼科常规检查。取随访期间最佳矫正视力(BCVA)，利用OCT的分析模式，分别测量手术前黄斑裂孔的最小直径、基底直径、裂孔高度、黄斑区视网膜厚度。用SPSS13.0软件包，比较术前黄斑裂孔自身形态测量值与术后BCVA的相关性。

结果：术后BCVA与术前黄斑裂孔的最小直径和基底直径(r=-0.524，-0.610， P<0.01)呈负相关； 与裂孔高度，黄斑区视网膜厚度(r=-0.064，0.003， P>0.05)无明显相关性； 与术前黄斑裂孔(maculer hole index， MHI)，临床观察，取MHI=0.5为分界值，MHI≥0.5组的患者术后视力明显优于MHI<0.5组(Mann-Whitney Test， P<0.01)； 手术治疗后的IMH患者BCVA较术前明显提高。

结论：黄斑裂孔的最小直径，基底直径越小，术后视力恢复越好。MHI计算简便，MHI≥0.5的患者手术后视力恢复较好，可作为手术选择的指标。玻璃体切割联合内界膜剥除手术治疗特发性黄斑裂孔有良好效果。

AIM:To observe the optical coherence tomography(OCT)images of idiopathic macular hole(IMH)on patients before and after vitrectomy and internal limiting membrane peeling(ILMP)surgery, and to analyze the relationship between the macular hole configuration and the postoperative best corrected visual acuity so as to offer a potential index to effectively predict visual outcome in eyes with idiopathic macular holes.

METHODS: A total of 32 consecutive patients of IMH(7 males, 25 females)receiving the operation of PPV and ILMP were performed with routine ophthalmologic and OCT examination before and after the operation. The best-corrected visual acuity(BCVA)in the follow-up period was recorded. The minimum diameter, the base diameter, the hole height before the operation, and the macular retinal thickness before and after the operation were measured respectively by the analytical model of OCT. The correlation between macular hole index(MHI)and BCVA post operation was analyzed using SPSS 13.0.

RESULTS: The negative correlation was observed between the post operative BCVA and the minimum diameter and the base diameter before the operation(r=-0.524, -0.610, P<0.01); There were no significant correlation between the post operative BCVA and the hole height and the macular retinal thickness(r=-0.064, 0.003, P>0.05). The positive correlation was observed between the postoperative BCVA and the MHI before operation(r=0.457, P<0.01); The cut-off value of MHI was defined as 0.5 by clinical observation. Postoperative BCVA in the MHI ≥0.5 group was much better than that in the MHI<0.5 group(Mann-Whitney Test, U=30.0, W=135, P<0.01). The postoperative BCVA of patients with IMH was much better than that before the operation.

CONCLUSION: The smaller the minimum diameter and the base diameter is, the better the post operative BCVA. The MHI is easy to calculate, and patients of MHI ≥0.5 have a better postoperative BCVA, MHI can be used as clinical evaluation-index for operation selection. The PPV combined with IMLP can effectively treat the IMH based on the OCT result.