Inverted ILM flap technique can achieve good anatomical and functional success in large, long standing macular holes or in non idiopathic macular holes (as macular holes related to myopia, post vitrectomy for retinal detachment or post ocular trauma).


Since July 2009 inverted ILM flap technique has been performed in macular hole with poor anatomical prognosis. ILM is incompletly peeled around the border of the hole and one and a half macular hole diameter of ILM is left free and carefuly inverted into the macular hole.This technique was used in 60 macular holes of 59 patients, by 8 surgeons in 4 departments. Forty eight cases were long standing and/or large idiopathic macular holes, 9 followed a vitrectomy, 2 were traumatic macular holes and 2 were related to high myopia. Thirty one patients were female and average age was 66 years old. Average minimum diameter of macular hole was 598┬Ám and known meanduration time was 29 months (8 cases had more than 5 years of evolution). Mean follow up time was 9 months.


Anatomical closure ratewas 97% and average BCVA improved from 0,087 to 0,284 at last follow-up.