Idiopathic age-related macular fissures occur mainly in refractively normal elderly people over 60 years of age, and are more common in women. It is believed that during the age-related change of vitreous detachment after liquefaction, the posterior vitreous cortex adheres tightly to the optic disc and macula, and the central concave vitreous produces vertical traction on the retina, resulting in the initial horseshoe hole-like fissure pattern, which continues to expand due to the parallel traction of the inner retinal boundary membrane around the hole. Stage I is also known as pre-hole stage: the central concavity disappears and flattens, and the hole is about to occur, with yellow dots or rings in the central concavity, no posterior vitreous detachment, and mild loss of vision. Stage II: Early hole formation in the form of semilunar, horseshoe-shaped or oval-shaped fissure, with aperture diameter mostly <400um, the fissure flap is tracted by the vitreous, vision gradually decreases and visual distortion occurs. Stage III: >400um, which can last for months or years. The contraction of the anterior retinal membrane at the edge of the hole causes wrinkling of the inner boundary membrane, and shallow retinal detachment at the edge of the hole is seen. Stage IV: The vitreous detaches not only from the macula, but also from the optic disc, and the Weiss ring is visible. As the disease progresses a central dark spot gradually appears, visual distortion increases and visual acuity decreases further. stage II-IV is a total lamellar hole, visual acuity decreases to 0.1 in most patients after the formation of a total lamellar hole, and continues to decrease to 0.05 in a few cases. laser around the macular hole can lead to continued destruction of visual acuity. The goal of vitreous surgery intervention is to close the fissure and stop the progression of the lesion. The rate of fissure closure after surgery is as high as 90% and the rate of visual acuity improvement is 50-70%. The degree of visual acuity improvement is influenced by the preoperative course of the disease and the level of visual acuity. The indications for surgery are selected for stage II-IV macular fissures, and visual acuity criteria are selected for patients with visual acuity below 0.5 whenever possible. However, it also depends on the experience of the operator and the patient’s requirements.