Macular fissure is a common eye disease in the elderly, especially in people with high myopia. Many people are very panic when they find out that they have this disease, therefore, there are many questions, now we focus on answering as follows: First, what is macula? In the center of this negative, there is a structure called “macula” because it contains lutein. The macula is the most important structure of our vision, it controls our central, daily vision including color vision, shape vision and light vision. Therefore, if there is a problem with the macula, it will definitely affect the central vision. Macular fissure 1.What is macular fissure (macular hole): It is a retinal fissure in the macular region, which is caused by various reasons of damage to the retinal tissue in the macular region, and a tissue defect occurs in the retinal inner boundary membrane to the photoreceptor cell layer, forming a fissure. If the retinal tissues in the macula area are completely damaged, it is called full-layer macular hole, if the retinal tissues in the macula area are still preserved and not completely damaged, it is called lamellar macular hole. 2.Why do you get macular fissure? The causes of macular fissure are vitreous macular traction, high myopia and trauma. But the most common one is due to the concentration and coalescence of vitreous with age, the combination of vitreous and retina is loosened, and then the separation of vitreous and retina (post-detachment) occurs, in the process of detachment, because the macular area is very tightly combined, sometimes it can lead to the retinal tissue in the macular area being torn off, and a macular hole is formed. Therefore, this type of macular fissure is called idiopathic macular fissure, which is also an aging phenomenon. Third, what are the symptoms of macular fissure? Reduced central vision and color vision, dark shadows in the center of the vision, or distortion of the vision. It mainly affects reading and seeing fine objects. If elderly people find the above symptoms, they should seek medical attention in time. You can usually observe some straight objects, and if there is absence or dark shadow, you should go to hospital for examination. IV. Staging of macular hole V. How to diagnose macular fissure? Doctors can completely confirm the diagnosis through fundoscopy and OCT examination. Especially OCT, it is clear at a glance. Macular lamina cleft Six, how to treat macular hole? Drug treatment is ineffective! Macular lacunae caused by trauma and high myopia are mostly accompanied by retinal detachment and need surgery. Most of the idiopathic macular fissures also need surgical treatment. The first stage can be observed, and part of it can be improved without treatment; the second and third stages are the best time for surgical treatment; the fourth stage is not ideal for vision recovery after surgery. Seven, the method of macular fissure surgery? The surgical method of macular fissure: to perform vitrectomy, remove the vitreous around the macular hole, most of them need to do the tearing of the inner retinal boundary membrane, and it is possible to fill the vitreous cavity with gas after the operation to promote its healing. For people with highly myopic macular hole, the surgery often uses silicone oil filling, and the head-down or prone position will have to be longer, some even require 3-4 weeks. It is still more painful. Eight, post-operative precautions? If the gas is filled, a short-term prone position is usually required, and the gas should not be taken by airplane until it is absorbed, and attention should be paid to the plateau area to avoid gas expansion, which will cause the IOP to rise. After surgery, the IOP and OCT should be reviewed regularly. IX. What are the healing criteria and success rate of the surgery? Surgical healing does depend on the size of the fissure and the duration of the disease, but the general success rate is about 80%. The success rate of high myopia macular fissure is a little lower. The criterion for healing is that the fissure is closed, or the edge of the fissure is tightly attached to the retinal pigment epithelium without buckling and edema, which is also a form of healing, especially in macular fissures caused by high myopia. Visual acuity improvement is not a criterion for success. Although there is also partial improvement of visual acuity. X. Other problems 1.Cost: generally around 8000 2.Hospitalization days: generally 3-5 days 3.Prevention: there is no good prevention method. 4.For patients who have macular fissure and don’t want to have surgery: first of all, don’t be nervous, pay attention to eye maintenance, such as excessive eye use, long time reading magazines, etc. Especially avoid excessive vibration of the eye to prevent retinal detachment due to macular fissure. If suddenly there is a large black shadow covering in front of your eyes or a large number of floating objects appear, it indicates that the retina may have detached and should be treated promptly. You should go to the hospital immediately if you find the condition.