To report the surgical technique and efficacy of the inverted internal limiting membrane (ILM) flap technique for an idiopathic macular hole (MH) in high myopia.

Case presentation:

A 47-year-old female with a full thickness macular hole with foveoschisis underwent pars plana vitrectomy with 23 gauge plus transconjunctival system, ILM peeling and SF6 gas tamponade. Axial length was 29.96mm and best corrected visual acuity was 0.06 before surgery. The inverted ILM flap technique was adopted. Surgical outcome was confirmed with optical coherence tomography (OCT). Complete closure of the macular hole with resolution of foveoschisis was confirmed on OCT at 1month postoperatively. Visual acuity improved from a baseline level of 0.06 to 0.2.


Inverted ILM flap technique might contribute to a high closure rate of macular hole and may be a good option to achieve MH closure in high myopia.

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