Modified Superior Inverted Internal Limiting Membrane Flap Technique With Vitrectomy Versus Vitrectomy With Internal Limiting Membrane Peeling For Retinal Detachment With Myopic Macular Hole

Abstract Purpose: To evaluate the efficacy of the modified superior inverted internal limiting (ILM) membrane flap technique in retinal reattachment, macular hole closure and external retinal layers restoration in macular hole associated retinal detachment compared to ILM peeling. Methods: Retrospective case series of 10 patients that required pars plana vitrectomy for retinal detachment with macular hole followed for more than 12 months. Data from medical records were retrospectively collected and patients were divided into the superior inverted flap (5 patients) and ILM peeling group (5 patients). We compared best corrected visual acuity (BCVA) before and after surgery, retinal attachment, macular hole closure rate and external retinal layer restoration between groups. Results: There were significant improvements in BCVA in both groups before and after surgery, with no differences between the two groups at 12 months after surgery (p = 0.9). The macular hole closed in 100% of cases in the inverted flap group and 80% of the ILM peeling group with no significant differences between groups. The retina was reattached in 100% of cases in both groups. Only 2 patients in the inverted flap group (40%) had external retinal layer restoration and none in ILM peeling group (p=0,62). Conclusions: ILM peeling and superior inverted flap techniques are useful for treating retinal detachment with macular hole in myopic eyes.