Closure of large macular holes

Abstract

AbstractPurpose: Despite the variety of different techniques for large macular holes (LMH) closure, this task is still challenging, especially in patients with myopia. We compared closure rates of LMH achieved by conventional internal limiting membrane (ILM) peeling and inverted ILM flap.Methods: Material and Methods. We represent single‐surgeon series of 42 consecutive treatment‐naive patients (pts) with LMH and myopia, for 21 pts retinal detachment (RD) was confirmed either before or during surgery. Initially we performed conventional ILM peeling (CP) – 17 pts, 8 with RD; starting from 2017 all patients were operated with inverted ILM flap (IF) technique – 25 pts, 13 with RD.Results: Results. Conventional ILM peeling allowed us to attain LMH closures in 3 of 8 pts with RD (33%) and 4 of 9 pts without RD only. Again, we achieved closures of LMH in all patients (with and without RD), operated with IF technique. In one patient operated with inverted ILM flap technique, we observed gliotic changes along the line of overlapping, but without significant loss of vision.Conclusions: Conclusion. Inverted ILM flap technique serves as a novel exceptionally effective approach for LMH closure in myopic patients. We found no influence of retinal detachment on the effectiveness of IF technique.