To present causes and surgical technique for reoperations in failed macular hole surgery in eyes previously operated with the inverted ILM flap technique.


11 eyes (6% of cases operated between 01.2008- 12.2011). During repeated surgery in all cases it was found that the inverted ILM flap reapproximated into its original position and did not close the macular hole. The ILM flap was put once again over the macular hole with ILM forceps and secured in its position either with air (2 eyes) or with silicone oil (9 eyes). Silicone was removed in all eyes. Spectral Domain OCT was performed before surgery and 1 week, 3, 6 and 12 months postoperatively.


All 11 macular holes were closed after the repeated surgery, which was confirmed with SD-OCT. Initial visual acuity was 1.09 LogMAR and improved 12 months postoperatively to 0.52 LogMAR. Repeated surgery after failed inverted ILM flap technique is a successful procedure and the inverted ILM flap must be safely put over the macular hole. Manipulations with inverted ILM flap seem to be easier after silicone oil injection, when compared to air.