目的：观察玻璃体切除联合带蒂的非翻瓣内界膜(ILM)转位手术治疗大直径黄斑裂孔(macular hole，MH)的效果。

方法：前瞻性研究。2016-12/2017-02于江苏省人民医院收治的9例10眼经频域光学相干断层扫描(SD-OCT)确诊为大直径MH患者(MH>400μm)，进行玻璃体切除联合ILM转位术。术前、术后1d，1wk，1、3、6mo随访SD-OCT、最佳矫正视力(best corrected visual acuity，BCVA)及微视野检查。

结果：患者裂孔闭合率为100%； 术前BCVA(LogMAR)1.19±0.54，术后视力提高显著，末次随访0.70±0.50(P=0.005)； 黄斑8°平均视网膜光敏感度(MS)值术前3.14±4.52dB、术后末次随访8.91±5.53dB(P=0.008)； 黄斑2°MS值术前1.46±2.94dB、术后末次随访6.33±4.90dB(P=0.008)。术前固视不稳定8眼，术后末次随访固视不稳定1眼。

结论：玻璃体切除联合内界膜转位手术可以有效治疗大直径MH，具有较高的裂孔闭合率，术后视功能改善显著。

METHODS: This was a prospective pilot study which included 9 patients with 10 eyes in Jiangsu Province People's Hospital from December 2016 to February 2017. All patients was diagnosed with large MH(size >400μm)by the spectra-domain optical coherence tomography(SD-OCT)and underwent the non-inverted pedicle ILM flap transposition surgery. Best-corrected visual acuity(BCVA), SD-OCT images, and MP-1 microperimetry tests were performed pre-operation, 1d, 1wk, 1, 3, and 6mo post-operation.

RESULTS: The macular hole closure rate after 6mo was 100%. The averaged BCVA improved from 1.19±0.54(LogMAR)pre-operation to 0.70±0.50(LogMAR)post-operation(P=0.005). The mean retinal sensitivity within 8° and 2° improved from 3.14±4.52dB to 8.91±5.53dB(P=0.008), and 1.46±2.94dB to 6.33±4.90dB(P=0.008)respectively. Preoperative unstable fixation in seven eyes resolved at the last postoperative follow-up.

CONCLUSION: Our non-inverted pedicle internal ILM flap transposition technique shows effectiveness in the treatment of large macular holes with high MH closure rate and improving visual function.