Successful Closure of Iatrogenic Double Macular Hole Using inverted Internal Limiting Membrane Flap Technique-Case Report

Purpose: To present a case study describing inverted internal limiting membrane flap technique used after failed treatment of double large fullthickness macular hole. Case presentation: A 79-year-old woman presented large full-thickness macular hole after primary failed pars plana vitrectomy with internal limiting membrane (ILM) peeling and SF6 gas endotamponade. The corrected distance visual acuity (CDVA) was 0.1 (Snellen chart). Optical coherence tomography (OCT) revealed two fullthickness macular holes. The first one of central location 825 μm in based diameter, and the second of nasal location 575 μm in based diameter. For this reason the patient was performed 25G posterior vitrectomy with inverted internal limiting membrane flap technique. The follow-up examinations were performed on day 1,7,30,180 postoperatively. Finally visual acuity was 0.4 (Snellen chart). Postoperative OCT confirmed MHs closure with the preservation of foveal profile. Conclusion: It seems, that in the case of full-thickness macular hole which was not closed after the first surgery and even there came to a complication and the formation of iatrogenic full-thickness macular hole, the use of inverted internal limiting membrane flap technique can be a good solution.