An Innovative Pear Flower Petal-Shaped Inverted Internal Limiting Membrane Flap Technique for Macular Holes with or Without Retinal Detachment-There is Always a Flap That Works for You.

Abstract

To introduce a modified, effective, and versatile inverted internal limiting membrane flap technique, providing a novel option for the treatment of macular holes, with or without retinal detachment. We conducted a retrospective analysis of 20 patients (20 eyes) with macular holes who underwent pars plana vitrectomy using the pear flower petal-shaped inverted internal limiting membrane flap technique. Best-corrected visual acuity, optical coherence tomography, and morphological assessments were performed at baseline and during each postoperative follow-up visit. Postoperative macular holes closure and retinal reattachment rates were both 100%. The baseline best-corrected visual acuity was logMAR 1.892 ± 0.495, which significantly improved to logMAR 0.968 ± 0.348 at the final follow-up ( P < 0.001). Optical coherence tomography imaging demonstrated favorable postoperative retinal microstructural recovery, with a healing process highly similar to that observed in spontaneous closures. This novel technique promotes anatomical and functional recovery in patients with macular holes, with or without retinal detachment, resembling the natural healing process. It serves as a remedial measure in case of intraoperative complications, offering a simple and flexible approach, ensuring that there is always a suitable flap for each situation.