Free ILM Flap-Assisted Closure of Failed Macular Hole

In this surgical video, Dr. Deependra Singh and colleagues describe a free ILM flap technique for failed macular hole. The ILM flap is peeled off and repositioned over the hole, making sure there is excess flap in the temporal direction to compensate for potential shifts during fluid-air exchange. The surgeons used 16% C3F8 gas for tamponade. Postoperative OCT scans at the 2-week follow-up showed the flap over an open macular hole. At the 10-week follow up, the hole is closed along with restoration of ELM and photoreceptors in most areas. The patient’s vision improved from 20/300 at baseline to 20/80 at 11 weeks postop.

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