Macular hole is one of the more common eye diseases that can seriously affect central vision. Optical Coherence Tomography (OCT) examination can accurately diagnose the disease. It is common in the elderly, eye trauma, and high myopia. Macular lentigines that occur without any other cause, called idiopathic macular lentigines are the most common. It often occurs at the age of 60-80 years. It can be divided into 4 stages; Stage I macular laceration shows loss of the normal macular central concavity, a hypo-reflective area underneath, no rupture of the inner macular tissues, and vitreous traction visible in the central concavity area. Stage II OCT images showed rupture of the inner surface of the retina with small, full-layer retinal tissue loss. Stage III macular lacunae show a well-demarcated centro-concave full-layer retinal defect with an increased rim thickness of the retinal neuroepithelial layer, accompanied by decreased light reflex and intraretinal edema, sometimes with hyperechoic anterior pseudoholecap of the lacunae. Stage IV shows a full macular tear with complete detachment of the vitreous from the macula and optic disk. In earlier years, it was often treated with laser closure, which is no longer used because it can cause vision loss. Minimally invasive vitreous surgery with inner border membrane peeling is now the treatment of choice for idiopathic macular hole de. Theoretically, the earlier the surgery, the better the result, the choice of surgery depends on the following aspects: 1, the technical level of the surgeon; 2, the surgical equipment; 3, the patient’s economic and psychological ability to withstand. In the past 5 years, with the gradual improvement of vitreous surgery technology, the constant updating of instrumentation, and the improved understanding of the mechanism of the disease, its surgical indications have been expanded. At present, there is no uniform standard for the surgical treatment of idiopathic macular lentigines, and patients with general stage II to IV holes are the target of surgery.