In 250 eyes with retinal detachment due to macular hole, the visual prognosis of each surgical technique was evaluated. (1) Macular diathermy adversely affected the visual prognosis. (2) Macular buckling + macular diathermy produced a poorer visual prognosis than macular buckling alone. (3) The visual prognosis resulting from gas tamponade alone or vitrectomy + gas tamponade was better than that resulting from macular diathermy. It is not clear whether there is a significant difference in visual prognosis between gas tamponade alone and vitrectomy + gas tamponade. (4) Macular laser photocoagulation does not adversely affect the visual prognosis. Judging from these results, gas tamponade, which has the possibility of better visual prognosis and less operation stress, should be selected as the initial technique.