Objective:To observe the efficacy and safety of pars plana vitrectomy (PPV) combined with subretinal injection of dexamethasone in treating refractory diabetic macular edema (DME).Methods:A prospective case study. From January 2024 to March 2024, 9 cases with 10 eyes of refractory DME diagnosed at Tianjin Eye Hospital were included in the study. All eyes had a central macular thickness (CMT) of greater than 275 μm despite receiving intravitreal injection of anti-vascular endothelial growth factor (VEGF) drug at least 5 times. All eyes underwent 25G PPV combined with internal limiting membrane (ILM) peeling and subretinal injection of dexamethasone sodium phosphate. Best-corrected visual acuity (BCVA), microperimetry, and optical coherence tomography examinations were performed on all eyes before and 1 and 3 months after surgery. BCVA was assessed using an international standard visual acuity chart and converted to logarithm of the minimum angle of resolution (logMAR) for statistical analysis. Paired t-tests were used to compare changes in BCVA, mean macular sensitivity (MS), and CMT before and after surgery. The intraoperative and postoperative complications were recorded.Results:Among the 9 cases with 10 eyes, there were 4 males with 5 eyes and 5 females with 5 eyes. Age ranged from 43 to 79 (65.3±10.8) years. Preoperative and postoperative logMAR BCVA at 1 and 3 months were 0.84±0.25, 0.72±0.31, and 0.63±0.22, respectively. MS was (16.48±5.03), (16.6±6.31), and (18.0±5.33) dB, respectively. CMT was (437.5±90.4), (306.9±87.4), and (288.7±87.3) μm, respectively. Compared with data before surgery, BCVA: the difference was not statistically significant at 1 month ( t=2.025, P=0.074), but was statistically significant at 3 months ( t=5.161, P=0.001), MS: the differences at 1 and 3 months were not statistically significant ( t=-0.078, -1.022, P=0.940, 0.334), CMT: the differences were of statistical significance at both 1 and 3 months ( t=2.892, 3.175, P=0.018, 0.011), and the difference between 1 and 3 months post-surgery was also statistically significant ( t=2.427, P=0.038). No complications such as macular hole, vitreous hemorrhage, or retinal detachment occurred during or after surgery in any eyes. No cases of increased intraocular pressure or cataracts were reported during the follow-up period. Conclusion:PPV combined with ILM peeling and subretinal injection of dexamethasone can effectively reduce CMT in refractory DME eyes and improve visual acuity, with good safety.

Objective:To observe the hemodynamic changes in the retina and choroid after scleral buckling surgery in eyes with rhegmatogenous retinal detachment (RRD).Methods:A prospective clinical observational study. A total of 25 eyes of 25 patients with RRD who underwent scleral buckling surgery in Tianjin Eye Hospital from February to April 2024 were included in the study. Among them, 10 were male and 15 were female. Age was 17-68 years old. All cases were monocular. The surgical eye and the contralateral healthy eye were divided into the affected eye group and the contralateral healthy eye group respectively. Best corrected visual acuity (BCVA), scanning source optical coherence tomography angiography (SS-OCTA), and axial length (AL) measurements were performed 3 months after surgery. SS-OCTA examination of macular area was performed by VG200 of Visual Microimaging (Henan) Technology Co., LTD. Scanning range 21 mm×26 mm. According to the partitioning method of the early treatment group of glycosuria retinopathy, the retina within 21 mm of the macular fovea was divided into concentric circles with the macular fovea as the center and diameters of 1-3, 3-6, 6-12, 12-21 mm, respectively. The built-in software of the device was used to record the central area (12 mm×12 mm in the fovea of the macula) and the peripheral area (12-21 mm range) retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillaries (RPC) blood density and choroidal vascular index (CVI), choroidal vascular volume (CVV), and 1-3, 3-6, 6-12, 12-21 mm above concentric circles (S), nasal side (N), temporal side (T), and lower side (I) SCP, DCP, and RPC blood flow density. Quantitative data between the two groups were compared by independent sample t test or Wilcoxon signed rank test. The correlation between retinal and choroid blood flow parameters and postoperative BCVA was analyzed by Spearman correlation analysis. Results:Compared with the opposite healthy eye group, SCP blood density in the central area ( Z=-4.372), DCP blood density in the central area ( Z=-2.829), and CVI in the peripheral area ( Z=-2.138) were decreased in the affected eye group, and the differences were statistically significant ( P<0.05). SCP: in the affected eye group, the blood flow density in T 3-6 mm, T 6-12 mm, N 6-12 mm and T 12-21 mm regions decreased, while the blood flow density in I 6-12 mm regions increased, with statistical significance ( P<0.05). DCP: blood flow density in S 6-12 mm, I 6-12 mm, S 12-21 mm and I 12-21 mm regions decreased significantly, and the differences were statistically significant ( P<0.05). RPC: blood flow density decreased significantly in T 6-12 mm and I 12-21 mm, and the differences were statistically significant ( P<0.05). CVI: T 6-12 mm, S 12-21 mm, T 12-21 mm, I 12-21 mm significantly decreased, and T 1-3 mm, S 12-21 mm significantly increased, the differences were statistically significant ( P<0.05). Correlation analysis showed that AL growth was positively correlated with CVV in central region ( r=0.408, P=0.040). The number of pad pressure was negatively correlated with the blood density of central DCP ( r=-0.422, P=0.030). Conclusions:After scleral buckling operation, the blood flow density and choroidal blood flow parameters in RRD affected eyes are lower than those in contralateral healthy eyes in some areas. The increase of AL is positively correlated with CVV in the central region, and the wider the range of pad pressure, the worse the recovery of DCP blood density.

Objective:To observe the efficacy and safety of pars plana vitrectomy (PPV) combined with subretinal injection of dexamethasone in treating refractory diabetic macular edema (DME).Methods:A prospective case study. From January 2024 to March 2024, 9 cases with 10 eyes of refractory DME diagnosed at Tianjin Eye Hospital were included in the study. All eyes had a central macular thickness (CMT) of greater than 275 μm despite receiving intravitreal injection of anti-vascular endothelial growth factor (VEGF) drug at least 5 times. All eyes underwent 25G PPV combined with internal limiting membrane (ILM) peeling and subretinal injection of dexamethasone sodium phosphate. Best-corrected visual acuity (BCVA), microperimetry, and optical coherence tomography examinations were performed on all eyes before and 1 and 3 months after surgery. BCVA was assessed using an international standard visual acuity chart and converted to logarithm of the minimum angle of resolution (logMAR) for statistical analysis. Paired t-tests were used to compare changes in BCVA, mean macular sensitivity (MS), and CMT before and after surgery. The intraoperative and postoperative complications were recorded.Results:Among the 9 cases with 10 eyes, there were 4 males with 5 eyes and 5 females with 5 eyes. Age ranged from 43 to 79 (65.3±10.8) years. Preoperative and postoperative logMAR BCVA at 1 and 3 months were 0.84±0.25, 0.72±0.31, and 0.63±0.22, respectively. MS was (16.48±5.03), (16.6±6.31), and (18.0±5.33) dB, respectively. CMT was (437.5±90.4), (306.9±87.4), and (288.7±87.3) μm, respectively. Compared with data before surgery, BCVA: the difference was not statistically significant at 1 month ( t=2.025, P=0.074), but was statistically significant at 3 months ( t=5.161, P=0.001), MS: the differences at 1 and 3 months were not statistically significant ( t=-0.078, -1.022, P=0.940, 0.334), CMT: the differences were of statistical significance at both 1 and 3 months ( t=2.892, 3.175, P=0.018, 0.011), and the difference between 1 and 3 months post-surgery was also statistically significant ( t=2.427, P=0.038). No complications such as macular hole, vitreous hemorrhage, or retinal detachment occurred during or after surgery in any eyes. No cases of increased intraocular pressure or cataracts were reported during the follow-up period. Conclusion:PPV combined with ILM peeling and subretinal injection of dexamethasone can effectively reduce CMT in refractory DME eyes and improve visual acuity, with good safety.

Objective:To observe the hemodynamic changes in the retina and choroid after scleral buckling surgery in eyes with rhegmatogenous retinal detachment (RRD).Methods:A prospective clinical observational study. A total of 25 eyes of 25 patients with RRD who underwent scleral buckling surgery in Tianjin Eye Hospital from February to April 2024 were included in the study. Among them, 10 were male and 15 were female. Age was 17-68 years old. All cases were monocular. The surgical eye and the contralateral healthy eye were divided into the affected eye group and the contralateral healthy eye group respectively. Best corrected visual acuity (BCVA), scanning source optical coherence tomography angiography (SS-OCTA), and axial length (AL) measurements were performed 3 months after surgery. SS-OCTA examination of macular area was performed by VG200 of Visual Microimaging (Henan) Technology Co., LTD. Scanning range 21 mm×26 mm. According to the partitioning method of the early treatment group of glycosuria retinopathy, the retina within 21 mm of the macular fovea was divided into concentric circles with the macular fovea as the center and diameters of 1-3, 3-6, 6-12, 12-21 mm, respectively. The built-in software of the device was used to record the central area (12 mm×12 mm in the fovea of the macula) and the peripheral area (12-21 mm range) retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillaries (RPC) blood density and choroidal vascular index (CVI), choroidal vascular volume (CVV), and 1-3, 3-6, 6-12, 12-21 mm above concentric circles (S), nasal side (N), temporal side (T), and lower side (I) SCP, DCP, and RPC blood flow density. Quantitative data between the two groups were compared by independent sample t test or Wilcoxon signed rank test. The correlation between retinal and choroid blood flow parameters and postoperative BCVA was analyzed by Spearman correlation analysis. Results:Compared with the opposite healthy eye group, SCP blood density in the central area ( Z=-4.372), DCP blood density in the central area ( Z=-2.829), and CVI in the peripheral area ( Z=-2.138) were decreased in the affected eye group, and the differences were statistically significant ( P<0.05). SCP: in the affected eye group, the blood flow density in T 3-6 mm, T 6-12 mm, N 6-12 mm and T 12-21 mm regions decreased, while the blood flow density in I 6-12 mm regions increased, with statistical significance ( P<0.05). DCP: blood flow density in S 6-12 mm, I 6-12 mm, S 12-21 mm and I 12-21 mm regions decreased significantly, and the differences were statistically significant ( P<0.05). RPC: blood flow density decreased significantly in T 6-12 mm and I 12-21 mm, and the differences were statistically significant ( P<0.05). CVI: T 6-12 mm, S 12-21 mm, T 12-21 mm, I 12-21 mm significantly decreased, and T 1-3 mm, S 12-21 mm significantly increased, the differences were statistically significant ( P<0.05). Correlation analysis showed that AL growth was positively correlated with CVV in central region ( r=0.408, P=0.040). The number of pad pressure was negatively correlated with the blood density of central DCP ( r=-0.422, P=0.030). Conclusions:After scleral buckling operation, the blood flow density and choroidal blood flow parameters in RRD affected eyes are lower than those in contralateral healthy eyes in some areas. The increase of AL is positively correlated with CVV in the central region, and the wider the range of pad pressure, the worse the recovery of DCP blood density.

Objective:To evaluate the efficacy and safety of 41G ultramicroneedle subretinal injection of balanced salt solution (BSS) in the treatment of large diameter macular holes (MH).Methods:A prospective clinical intervention study. A total of 22 eyes of 22 large-diameter full-layer MH patients diagnosed by examination in Tianjin Eye Hospital from March to June 2024 were included in the study. The minimum diameter of MH in the affected eyes was all greater than 400 μm. The affected eyes received 25G pars plana vitrectomy combined with internal limiting membrane peeling and 41G ultramicroneedle subretinal injection of BSS. The affected eyes underwent best-corrected visual acuity (BCVA), microperimetry, fundus autofluorescence, and optical coherence tomography (OCT) examinations before and 1 and 3 months after surgery. BCVA was measured using the standard logarithmic visual acuity chart and converted to logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical analysis. The minimum and base diameter of MH were measured using OCT. Microperimetry was performed using a macular integrity assessment device, recording the macular integrity index (MII) and macular threshold (MT) within 10° of the macular. The changes in BCVA, MII, MT, and the closure of MH and the occurrence of complications were compared and analyzed before and after surgery. For the comparison of the same continuous indicators before and after surgery, Student's t-test was used if the data were normally distributed and had equal variances, and the Mann-Whitney U test was used if the data were not normally distributed; the correlation between different indicators was analyzed using Pearson correlation analysis. Results:Among the 22 cases (22 eyes), there were 4 males and 18 females; all were unilaterally affected. The age was 66 (60, 71) years. The duration of the disease was 5 (2.5, 12.0) months. The logMAR BCVA of the affected eyes was 1.24±0.57, and the MII and MT were 100.0 (99.53, 100.00) and 19.0 (13.23, 21.78) dB, respectively. One month after surgery, all MH were closed, with 20 (90.91%, 20/22) and 2 (9.09%, 2/22) eyes classified as type Ⅰ and Ⅱ closure, respectively. At the last follow-up, the logMAR BCVA was 0.62±0.58, and the MII and MT were 99.9 (59.45, 100.00) and 23.6 (19.33, 26.25) dB, respectively; compared with before surgery, the BCVA ( t=3.579), MII ( Z=-2.374), and MT ( Z=-2.997) were significantly improved, and the differences were all statistically significant ( P<0.05). Correlation analysis showed that postoperative BCVA was significantly positively correlated with preoperative BCVA ( r=0.41), the minimum and base diameter of MH ( r=0.64, 0.58), disease duration ( r=0.63), and age ( r=0.50) ( P<0.05). No surgery-related complications occurred in all affected eyes during the follow-up period. Conclusion:41G ultramicroneedle subretinal injection of BSS can effectively improve the hole closure rate of large diameter MH-affected eyes in the short term, improve visual function, and has good safety.

Objective:To evaluate the efficacy and safety of 41G ultramicroneedle subretinal injection of balanced salt solution (BSS) in the treatment of large diameter macular holes (MH).Methods:A prospective clinical intervention study. A total of 22 eyes of 22 large-diameter full-layer MH patients diagnosed by examination in Tianjin Eye Hospital from March to June 2024 were included in the study. The minimum diameter of MH in the affected eyes was all greater than 400 μm. The affected eyes received 25G pars plana vitrectomy combined with internal limiting membrane peeling and 41G ultramicroneedle subretinal injection of BSS. The affected eyes underwent best-corrected visual acuity (BCVA), microperimetry, fundus autofluorescence, and optical coherence tomography (OCT) examinations before and 1 and 3 months after surgery. BCVA was measured using the standard logarithmic visual acuity chart and converted to logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical analysis. The minimum and base diameter of MH were measured using OCT. Microperimetry was performed using a macular integrity assessment device, recording the macular integrity index (MII) and macular threshold (MT) within 10° of the macular. The changes in BCVA, MII, MT, and the closure of MH and the occurrence of complications were compared and analyzed before and after surgery. For the comparison of the same continuous indicators before and after surgery, Student's t-test was used if the data were normally distributed and had equal variances, and the Mann-Whitney U test was used if the data were not normally distributed; the correlation between different indicators was analyzed using Pearson correlation analysis. Results:Among the 22 cases (22 eyes), there were 4 males and 18 females; all were unilaterally affected. The age was 66 (60, 71) years. The duration of the disease was 5 (2.5, 12.0) months. The logMAR BCVA of the affected eyes was 1.24±0.57, and the MII and MT were 100.0 (99.53, 100.00) and 19.0 (13.23, 21.78) dB, respectively. One month after surgery, all MH were closed, with 20 (90.91%, 20/22) and 2 (9.09%, 2/22) eyes classified as type Ⅰ and Ⅱ closure, respectively. At the last follow-up, the logMAR BCVA was 0.62±0.58, and the MII and MT were 99.9 (59.45, 100.00) and 23.6 (19.33, 26.25) dB, respectively; compared with before surgery, the BCVA ( t=3.579), MII ( Z=-2.374), and MT ( Z=-2.997) were significantly improved, and the differences were all statistically significant ( P<0.05). Correlation analysis showed that postoperative BCVA was significantly positively correlated with preoperative BCVA ( r=0.41), the minimum and base diameter of MH ( r=0.64, 0.58), disease duration ( r=0.63), and age ( r=0.50) ( P<0.05). No surgery-related complications occurred in all affected eyes during the follow-up period. Conclusion:41G ultramicroneedle subretinal injection of BSS can effectively improve the hole closure rate of large diameter MH-affected eyes in the short term, improve visual function, and has good safety.

Objective:To observe the changes of macular visual function after myopic foveoschisis (MF) and pars plana vitrectomy (PPV) combined with internal limiting membrane peeling and air filling.Methods:A single-center, retrospective study. From October 2018 to October 2019, 29 MF inpatients (32 eyes) in Tianjin Eye Hospital were included in this study. There were 3 males (4 eyes) and 26 females (28 eyes). The age was 63.00±3.45 years old. Equivalent spherical lens degree was -14.16±2.54 D, and axial length was 29.14±1.04 mm. Among them, 3 patients (3 eyes) had lamellar macular holes. All eyes underwent standard pars plana three-channel 25G PPV combined with internal limiting membrane peeling and air filling. Before surgery and at 1, 3, and 6 months after surgery, macular microperimetry was performed with a macular integrity assessment instrument, and the mean retinal sensitivitie (MS) within 10° of the macula, fovea 2° and 4° fixation rates (P1, P2), 63% and 95% bivariate contour ellipse area (BCEA) were recorded. The comparison of MS, P1, P2, 63%BCEA and 95%BCEA at different times before and after surgery was performed by paired t test; the comparison of fixation stability rate was performed by χ 2 test. Results:Compared with before surgery, there were significant differences in the improvement of MS in affected eyes at 1, 3 and 6 months after surgery ( t=-2.208, -3.435,-4.919; P=0.038, 0.002, 0.000). In the pairwise comparison at different times after surgery, only 6 months after surgery and 1 month after surgery were significantly different ( P=0.036). Compared with the preoperative P1, P2, 63%BCEA and 95%BCEA, the P1 and P2 of the eyes gradually increased after surgery, while the 63%BCEA and 95%BCEA gradually decreased, however, the difference was not statistically significant (P1: t=-1.595,-1.698,-1.966; P=0.125, 0.104, 0.062. P2: t=-1.622,-1.654,-1.707; P=0.119, 0.112, 0.102. 63%BCEA: t=1.410, 1.409, 1.553; P=0.172, 0.173, 0.135. 95%BCEA: t=1.412, 1.408, 1.564; P=0.172, 0.173, 0.132). Six months after surgery, all the eyes underwent anatomical repositioning of the macular area, and no serious complications such as full-thickness macular hole and macular hole retinal detachment were found. Conclusions:PPV with internal limiting membrane peeling and air filling is an effective and safe method for MF, and the macular function improved significantly within 6 months postoperatively.

Objective To observe the dynamic characteristics of visual acuity after vitrectomy in different sizes of idiopathic macular hole,and analyze the influencing factors.Methods A retrospective study.From August 2016 to June 2018,302 patients (302 eyes) with monocular idiopathic macular hole who underwent 25G vitrectomy combined with the internal limiting membrane peeling in Tianjin Eye Hospital were included in the study.There were 130 males and 172 females,with the mean age of 63.36 ± 6.91 years.There were 158 left eyes and 144 right eyes.The logMAR BCVA was 1.13 ± 0.45.The minimum diameter (422.92± 211.73 μm) and basal diameter (835.47± 366.42 μm) of macular hole and choroid thickness under fovea (244.84± 60.68 μm)were measured by OCT.According to the minimum diameter,the holes were divided into small hole group (≤ 250 μm),middle hole group (＞250 μm and ≤400 μm) and large hole group (＞400 μm).The logMAR BCVA at 1,3 and 6 months after surgery in 3 groups were observed.Two-factor repeated measure ANOVA was used to compare the visual acuity of the 3 groups.The generalized estimation equation (GEE) was used to analyze the influencing factors of postoperative visual recovery.Results One month after surgery,all the holes were closed.One,3 and 6 months after surgery,the logMAR BCVA were 0.33 ± 0.25,0.23 ± 0.18,0.16± 0.17 in the small hole group;the logMAR BCVA were 0.46±0.25,0.35±0.26,0.27±0.28 in the middle hole group;the logMAR BCVA were 0.81 ±0.51,0.61 ±0.48,0.53±0.37 in the large hole group.Through repeated measurement variance analysis of two factors,it was found that there was an interaction between different groups and different time nodes (F=23.133,P＜0.01).All data were segmented and one-way repeated measure ANOVA was performed.The results showed that there was a statistically significant difference in visual acuity between the small hole group and the middle hole group among preoperative and 1 month after surgery (P＜0.05),while there was no statistically significant difference in visual acuity between 1,3 and 6 months after surgery (P＞0.05).In the large hole group,among preoperative,1 months after surgery,3 months after surgery,the visual acuity difference was statistically significant (P＜0.05),while the visual acuity difference between 3 months after surgery and 6 months after surgery was not statistically significant (P＞0.05).The results of GEE analysis showed that hole size (X2=4.17,P=0.04),basal diameter (X2=7.25,P=0.01),disease course (X2=19.26,P=0.00),and choroid thickness (X2=4.19,P=0.04) were the influencing factors of postoperative visual acuity.Conclusions After vitrectomy of macular holes of different sizes,the visual recovery trend is different.The visual recovery of small holes and middle holes is faster and basically restored at 1 month.The large holes requires a slow recovery process and stabilizes vision at 3 months.Hole size,basal diameter,course of disease and choroid thickness are the influencing factors of visual acuity recovery.

Objective:To observe the healing morphology, macular microstructure and visual function of idiopathic macular hole (IMH) after pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) flap.Methods:Retrospective case study. From 2016 to 2018, 39 eyes of 39 patients with IMH diagnosed in Tianjin Eye Hospital were included in the study. Among them, there were 4 eyes in 4 males and 35 eyes in 35 females, with an average age of 64.56±7.2 years. BCVA, OCT, OCT angiography (OCTA) and MAIA microperimetry examination were performed in all patients. BCVA examination was performed with the international standard visual acuity chart, which was converted to logMAR visual acuity when recording. All patients underwent PPV combined with ILM flap covering and air tamponade. According to the characteristics of OCT images postoperatively, the eyes were divided into U-shaped closed group, V-shaped closed group, irregular closed group and flat closed group, with 26, 5, 7 and 1 eyes respectively. There was a significant difference in the minimum hole diameter ( F=5.118, P=0.005) and macular hole classification ( F=3.608, P=0.024). The shallow capillary layer (SCP) blood flow density in the U-shaped closure group was significantly higher than that in the V-shaped closure group, the irregular closure group and the flat closure group (t=2.079, 2.368; P=0.047, 0.025). At 1, 3, 6 months after the operation, the same equipment and methods were used for relevant examination. The blood flow density of BCVA, SCP, perimeter of foveal avascular zone (PERIM) and mean sensitivity (MS) were compared before and after operation. Independent sample t-test was used for quantitative data comparison between different groups, and χ2 test was used for counting data comparison. Results:Six months after operation, the logMAR of the eyes in the U-shaped closure group was -0.75±0.29 higher than that before operation, and was better than that in the V-shaped closure group, the irregular closure group and the flat closure group ( t=-2.974, -2.518; P=0.006, 0.018). The integrity of external limiting membrane (ELM) and ellipsoid in U-shaped closed group was significantly higher than that in V-shaped closed group, irregular closed group and flat closed group ( χ2=15.229, 10.809; P=0.020, 0.013). The percentage of macular central fovea reflex mass in the U-shaped closed group was significantly lower than that in the V-shaped closed group, irregular closed group and flat closed group ( χ2=20.107, P=0.000). PERIM in U-shaped closure group was smaller than that in V-shaped closure group, irregular closure group and flat closure group, and the difference was statistically significant ( t=-3.391, -2.427; P=0.002, 0.022). The total MS of macular area 10° in the U-shaped closure group was significantly higher than that in the other V-shaped closure group, irregular closure group and flat closure group ( t=2.939, 2.811; P=0.001, 0.001). Conclusion:After IMH operation, the U-shaped closure showed better BCVA and macular light sensitivity, the proportion of ELM and ellipsoid to restore structural integrity are higher, PERIM is smaller, and there are fewer macular fovea strong reflex masses.

Objective:To observe the changes of microperimeter and OCT angiography (OCTA) in idiopathic macular hole (IMH) before and after operation, and to explore the correlation between the changes and visual acuity.Methods:From January 2018 to January 2019, 41 patients (41 eyes) with IMH who underwent pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) flap surgery in Tianjin Eye Hospital were included in this study. Among them, 8 patients (8 eyes) were male and 33 patients (33 eyes) were female. The average age was 64.02±6.46 years. The average course of disease was 7.00±8.85 months. BCVA, microperimeter and OCTA were performed. The retinal mean sensitivity (RMS) at 10 ° and fovea 2 ° fixation rate (P1) and binary contour ellipse area (63% BCEA) were measured by macular integrity assessment instrument. The central retinal thickness (CRT), choroidal blood flow area (CFA), superficial and deep retinal blood flow density (FAVD, FDVD), foveal avascular zone (FAZ) and blood flow densitywithin the width of FAZ 300 μm (FD-300) were measured by OCTA. Twenty one and 19 eyes with or without ILM flap operation were treated with 25G standard three incision PPV. The follow-up time was more than 6 months. Paired t-test was used to compare the indexes before and after operation. Pearson correlation analysis was performed for the correlation between logMAR visual acuity and microperimeter variables and OCTA variables. Nonparametric test was performed for paired comparison between affected eyes and contralateral eyes before and after operation.Results:At 6 months after operation, logMAR visual acuity ( t=-12.33), RMS ( t=7.94), P1 ( t=3.21), 63% BCEA ( t=-3.98), CRT ( t=-9.17), CFA ( t=8.14), FSVD ( t=3.75), FDVD ( t=3.88) were significantly improved compared with those before operation ( P<0.001). The difference of FAZ area ( t=-1.40) and FD-300 ( t=1.95) before and after operation were not statistically significant ( P>0.05). The results of correlation analysis showed that logMAR visual acuity 6 months after surgery was correlated with preoperative logMAR visual acuity, MIN, RMS, P1, 63% BCEA, FSVD, FDVD and FAZ ( r=0.432、0.527、-0.410、-0.383、0.349、-0.406、-0.373、0.407; P<0.05). At 6 months after operation, the indexes of the affected eyes were significantly improved compared with those before operation, but worse than those of the contralateral eyes ( P<0.05). Conclusions:PPV for IMH can effectively improve the visual acuity, retinal function and foveal microvascular circulation. Retinal function and blood circulation changes have a significant impact on postoperative visual acuity.