Surgical repair of a giant idiopathic macular hole by inverted internal limiting membrane flap

Abstract

A 22-year-old male patient presented with gradual outward deviation of the right eye following corneal tear repair in that eye 8 years prior. He was asymptomatic in the left eye. On examination, his best corrected visual acuity was counting fingers at 2 m in the right eye and 20/80 in the left eye. The left eye showed a large macular hole, 2845 μm in diameter, with a retinal detachment at the posterior pole. The patient underwent pars plana vitrectomy, internal limiting membrane (ILM) peeling with inverted ILM flap technique and silicone oil injection. At the 1-week follow-up visit, there was growth of retinal tissue under the ILM flap. At 2-month follow-up, there was a complete closure of the macular hole and visual acuity was 20/100. At this time, the patient underwent removal of the silicone oil, following which visual acuity was maintained at 20/100.