Introduction:

Full-thickness idiopathic macular holes are foveal anatomic defects with a complete interruption of all retinal layers. This results in a significant visual impact for the patient. Current surgical options are constantly under debate, particularly after the new International Vitreomacular Traction Study Group classification. Various surgical options have been proposed to boost the closure rates in this disorder, namely vitrectomy combined with and extended ILM peel with or without an inverted flap. The authors present a different inverted flap technique, using liquid perfluorocarbon to help the positioning of the inverted flap.

Methods:

The authors present six cases of idiopathic full-thickness macular holes, that underwent vitrectomy with ILM peeling and inverted flap, using brilliant blue G as dye. The difference in the technique is that we isolate a superior temporal trapezoidal flap, after which we use liquid PFC to hold it securely in place, over the macular hole. The remaining procedure is performed and, at the end of the surgery, the PFC is removed during the air-fluid exchange. Then, we use SF6 to tamponade the eye.

Conclusions:

The different techniques available for macular hole surgery have resulted in increased anatomical and functional outcomes. Our experience with this different technique has been very favorable, in medium and large macular holes. So far, all cases have resulted in successful closure and a visual improvement.

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David da Fonseca Martins