Repeat Surgery in Failed Primary Vitrectomy for Macular Holes Operated With the Inverted ILM Flap Technique

Ophthalmic Surg Lasers Imaging Retina. 2018 Aug 1;49(8):611-618. doi: 10.3928/23258160-20180803-09.


Background and objective: Effects of repeat surgery in failed primary full-thickness macular hole (FTMH) closure with the inverted internal limiting membrane (ILM) flap technique.

Patients and methods: Retrospective analysis of patients operated with the inverted ILM flap technique. Optical coherence tomography was performed before initial and secondary surgeries and then at up to 12 months post-surgery.

Results: During the second surgery, the inverted ILM flap created at the first attempt had returned to its original position, instead of covering the FTMH. FTMH was closed in 29 eyes after second surgery (89%) and in all eyes after third surgery. Visual acuity improved in 28 of 32 cases (87.5%). The tamponade used (either silicone oil or air) did not influence final visual results (P = .06).

Conclusions: Repeat surgery with the inverted ILM flap technique is an effective method of treatment. Silicone oil improved anatomical outcome after second surgery but did not influence visual results. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:611-618.].

MeSH terms

  • Aged
  • Basement Membrane / surgery*
  • Epiretinal Membrane / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Reoperation
  • Retinal Perforations / surgery*
  • Retrospective Studies
  • Silicone Oils / administration & dosage
  • Surgical Flaps*
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Vitrectomy / methods*


  • Silicone Oils