Do I need surgery for macular fissure? [Help] I have noticed a gradual loss of vision in my left eye for more than six months, and in the past two weeks, I have experienced significant visual distortion. An OCT examination at an outside hospital revealed a fissure in the macular area, and the doctor gave me some medication, but no improvement was seen. The doctor suggested me to have an operation, but said that my vision would not improve and I am worried. Do I need surgery in this case? Can my vision be improved? [Comment] Macular fissure is a common eye disease in middle-aged and elderly people, the onset of which is mostly in women, mostly over 50 years old. The occurrence of macular fissure is mainly due to the traction of macular surface in the direction of vitreous tangent. Early onset is more insidious and will only be detected when the other eye is obscured, usually complaining of slowly developing central dark spot, blurred and distorted vision, etc. Idiopathic macular fissure is clinically classified into stages I-IV according to the different stages of fissure occurrence. Natural course: Stage I 50% develop into full lamina cleft, stage II has developed small off-center hole, 2-6 months develop to stage III cleft, while more than 50% of stage III holes develop to stage IV cleft. The early fissure vision is not significantly affected, once the macular fissure is formed, the vision will keep decreasing until it is below 0.1. [Countermeasures] Once the macular fissure appears, it will continue to grow, and only through surgical treatment can the fissure heal. After surgery, most of the patients’ vision can be stabilized, and some patients’ vision may be improved. In addition, the timing of surgery is very important, and it is generally believed that macular fissure is best operated in stage II-IV. According to your complaint, the macular fissure may have just formed, so we suggest you to receive surgery as soon as possible, so that the fissure may still close and your vision can be stabilized. At present, the minimally invasive vitrectomy adopted by our hospital can effectively remove the traction on the macular surface and promote the healing of the fissure. Moreover, the surgery is less invasive, quick recovery and effective, which is the preferred method for treating macular fissure. [Tips] The recovery of vision after macular lacunae surgery is related to the length of the disease, the size of the lacunae and whether the lacunae heals after surgery. Most patients feel that their vision is stable or improved after surgery, and the visual distortion is obviously better.