To describe the functional and anatomical results of pars plana vitrectomy (PPV) with inverted internal limiting membrane (ILM) flap for the treatment of macular holes with or without retinal detachment (RD) in highly myopic eyes.


Twenty-nine eyes affected by macular hole, associated (n=6) or not (n=23) with retinal detachment in high myopia (average axial length 26.80 mm) underwent PPV with inverted ILM flap.


The follow-up ranged from 1 to 7 months. Macular hole closure was observed in 22 eyes (4 %) without RD and in 6 eyes (100%) with RD; in this group, retinal attachment was achieved in the totality of cases. Best corrected visual acuity (BCVA) improved in all patients with and without RD. No worsening in BCVA was observed in both groups. Spectral-domain OCT (SD-OCT) revealed a progressive restoration of the outer retinal layers in most cases.


Inverted ILM flap technique seems to improve the anatomic and functional outcome of surgery for myopic macular hole. In our experience, it has become the technique of choice for the treatment of those challenging cases.