A randomized clinical trial to compare inverted ILM flap technique and standard macular hole surgery in terms of anatomical and functional outcomes for macular holes diameter greater than 400 micron

Aim: The aim of this is to evaluate the effects on vitrectomy with inverted internal limiting membrane (ILM) flap technique versus complete ILM peeling (standard macular hole surgery) for large diameter greater than 400 micron.Design: A prospective, randomized clinical trialParticipants: patients holes larger micron were included. In group A,75 eyes 75 underwent standard surgery peeling. in B,75 technique.Method: a remnant attached margins was left place. This then upside down cover hole. Spectral domain optical coherence tomography and examination performed before postoperatively at 1, 3, 6 and12 months.Main outcome measures: visual acuity closure.Results: Preoperative mean 0.0944 (Range 0.0630-0.1680) 0.0926 (range 0.0720-0.1430) B. closure observed 93.33% A, 100% B, flat open 33.33% A.13.33% Mean postoperative 12 months after 0.19 0.31 (p value 0.001each) which statistically significant.Conclusions: techniques prevents appearance improves both functional anatomic outcomes micron. suggests improved foveal anatomy compared surgery.