Macular Morphology after Macular Hole Surgery Using the Inverted Internal Limiting Membrane Flap Technique

Purpose:To investigate the influence of an excess inverted internal limiting membrane (ILM) flap that covers the fovea in idiopathic macular hole surgery on postoperative visual acuity and macular morphology.Methods:This retrospective study included 66 patients with an idiopathic macular hole who underwent vitrectomy using the inverted ILM flap technique. They were divided into three groups: normal morphology (N), detached ILM (D), or ILM proliferation (P) in the parafoveal area. They were followed up for at least 6 months, and their best-corrected visual acuity, central retinal thickness, and parafoveal retinal thickness were measured.Results:There were no significant differences in preoperative or postoperative mean best-corrected visual acuities or postoperative CRTs among the groups. The postoperative inferior parafoveal retinal thicknesses were 319.2 ± 38.0, 377.1 ± 60.6, and 373.1 ± 67.3 µm in the N, D, and P groups, respectively (P vs. D group, P = 0.963; P vs. N group, P = 0.008; N vs. D group, P = 0.004).Conclusion:Regardless of the postoperative morphology of the inverted ILM flap, there was no effect on postoperative best-corrected visual acuity or CRT.