Inverted ILM Flap Peeling for Large Macular Holes

In this interview from ASRS 2019, Dr. Francesco Boscia discusses an inverted ILM flap peeling technique for large macular holes. He performed a comparative, nonrandomized 12-month study using his technique for 92 patients with large, medium and small macular holes. Primary closure was achieved in 93% of patients with large macular holes, which was similar to what was observed in patients with small and medium holes. Dr. Boscia concludes that while vitrectomy with ILM flap is an effective technique for achieving flap closure for large holes, visual recovery is still guarded, likely due to lack of restoration of the outer retinal layers.

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