Macular fissure is a common eye disease in elderly people, especially those with high myopia, and some trauma patients can also develop this disease. What is macula? The human eye is like a camera, and the retina is equivalent to the negative of the camera. In the center of this negative, there is a structure called “macula” because it contains lutein. The macula is the most sensitive area for vision, and the cone cells responsible for vision and color vision are located in this area. Therefore, any lesion involving the macula will cause a significant decrease in central vision, darkness and distortion. Macular fissure 1.What is macular fissure: It is a retinal fissure that occurs 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 from the inner retinal membrane to the photoreceptor cell layer, forming a fissure. Macular lacunae are divided into lamellar lacunae and full-layer lacunae, which are mainly caused by inflammation, trauma, poisoning, degeneration and high myopia, etc., and develop from long-term macular cystoid edema. Macular fissure without other causes is called idiopathic macular fissure. 2.Why does macular fissure occur? The causes of macular fissure are vitreous macular traction, high myopia and trauma. However, 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. For example, the original straight line becomes curved, bright things become gray, etc. How to treat macular hole? Drug treatment is not effective! Macular fissure caused by trauma and high myopia is usually accompanied by retinal detachment and needs to be treated by surgery. Most of the idiopathic macular fissures also need surgical treatment. Once macular fissure is diagnosed, except for stage I patients who can partially heal themselves, the rest should be treated with surgery as soon as possible to obtain better postoperative vision. The surgical treatment of macular fissure The surgical treatment of macular fissure: vitrectomy should be performed to remove the vitreous around the macular hole, and do the tearing of the inner retinal membrane to completely release the retinal traction in the macula, and possibly fill the vitreous cavity with gas after the surgery to promote the healing of the fissure. 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 a month. At present, with the improvement of minimally invasive vitreous surgery technology more and more patients with macular fissure have been successfully treated surgically, the visual distortion has been improved and the vision has been improved. For old macular fissures or larger diameter macular fissures that used to be difficult to close, the retina can now be operated on through the retina to let down the shadows and feed on the hill. The patient will need to be filled with inert gas for a short period of time in a prone position, usually for about a week. Air travel is not allowed until the gas has been absorbed, as this may cause an increase in intraocular pressure due to gas expansion. As the intraocular gas is absorbed, the patient’s vision will gradually improve.