Abstract:  Idiopathic macular hole (IMH) is a full-thickness defect of retinal tissue involving the anatomic fovea and is the common cause of vision decrease among elderly women. Pars plana vitrectomy combined with gas tamponade is the standard treatment for IMH. Removal tangential or anteroposterior vitreofoveal traction is the key point to close IMH successfully. Tamponade agents have already evolved from silicon oil and long-acting gas (C3F8/C2F6) to short-acting gas (SF6/air). Filling with a more short-acting gas and alleviated face-down position may be the trend in future. It is the ultimate goal for treating IMH to recover the morphology and function of macula maximally and to improve the quality of life. To promote IMH closure spontaneously and restore visual function completely by non-surgical intervention may be the future direction.

Key words: idiopathic macular hole/surgery, tamponade agent, face-down