The temporal inverted internal limiting membrane flap technique versus multilayered inverted flap technique in patients with idiopathic macular hole

ObjectivesThis study aimed to compare the temporal inverted internal limiting membrane (ILM) flap technique with the multilayered inverted ILM flap technique for treating idiopathic macular holes (IMHs) by assessing anatomical outcomes using optical coherence tomography (OCT) and functional outcomes through best corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA).BackgroundILM flaps act as a scaffold that promotes macular hole closure by facilitating cell proliferation and migration.Patients and methodsPatients with IMHs were divided into two groups. Group A underwent the temporal inverted ILM flap technique, while group B received the multilayered inverted ILM flap technique. Preoperative assessment of BCVA, OCT and OCTA. Follow-up at 1, 3, and 6 months by OCT and assessment of BCVA, and OCTA at 3 months.ResultsThe study included 20 eyes with IMH: group A (mean age 60.9 +/- 4.51 years) and group B (mean age 62.7 +/- 3.74 years). Postoperative OCT revealed no significant differences in closure patterns between the groups. Group A had 60% type U, 10% type V, and 20% type W closure patterns, with 10% of cases failing to close. Group B had 70% type U, 20% type V, and 10% type W closure patterns. BCVA improved from 0.06 +/- 0.02 to 0.24 +/- 0.14 in group A and from 0.05 +/- 0.02 to 0.30 +/- 0.11 in group B.ConclusionWhile no significant anatomical differences were observed between the two techniques, the multilayered inverted ILM flap technique demonstrated superior functional outcomes compared with the temporal flap technique.