• Haroon Tayyab, Asad Aslam Khan, and Sana Jahangir.
• Dr. Haroon Tayyab, FCPS (Ophth), FCPS (VRO), Department of Ophthalmology, College of Ophthalmology & Allied Vision Sciences, King Edward Medical University, Lahore, Pakistan.
• Pak J Med Sci. 2019 Mar 1; 35 (2): 315-319.

ObjectiveTo evaluate the effectiveness of inverted internal limiting membrane flap in large idiopathic macular holes.MethodsTwelve patients diagnosed with idiopathic macular holes larger than 400um underwent 23 gauge Pars Plana Vitrectomy (PPV) with inverted internal limiting flap and gas tamponade at Al-Ehsan Eye Welfare Eye Hospital, Lahore from February 2017 to February 2018. All cases were diagnosed on Spectral Domain Optical Coherence Tomography (SD-OCT) and were followed up for 6 months. At every follow-up, best corrected visual acuity and SD-OCT was done.ResultsWe achieved macular hole closure in 91.6% (11/12) patients with idiopathic macular holes larger than 400um. Five out of 12 patients underwent combined phacoemulsification and PPV. One patient has flat hole closure which was considered failure. One patient was excluded from the study due to per-operative flap loss. This patient was not included in final data analysis of 12 patients. There was statistically significant gain in best corrected visual acuity after successful macular hole closure. We did not report any untoward events during or in the post-operative period.ConclusionInverted internal limiting flap is an effective method for repairing large macular holes.

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