Comparative Evaluation of Standard ILM Peel With Inverted ILM Flap Technique In Large Macular Holes: A Prospective, Randomized Study

BACKGROUND AND OBJECTIVE: To compare the outcomes of inverted internal limiting membrane (ILM) flap technique (IFT) with the standard ILM peel (SIP) for large macular holes (MHs). PATIENTS AND METHODS: This is a prospective, randomized study in which 100 patients with idiopathic MHs with minimum linear dimension of 600 μm or greater were recruited. Group 1 underwent SIP and group 2 underwent IFT. Best-corrected visual acuity (BCVA), type of MH closure, and multifocal electroretinogram (mfERG) were evaluated at presentation, 1 week, 1 month, and 3 months postoperatively. RESULTS: Mean postoperative BCVA was 0.86 ± 0.19 in group 1 and 0.67 ± 0.3 in group 2 at 3 months postoperatively ( P = .001). Type 1 closure was observed in 34.04% of patients in group 1 and in 62.79% of patients in group 2 ( P = .02). mfERG showed improvement in both groups. CONCLUSION: IFT provides superior outcomes compared to SIP and, hence, could be considered as the surgical modality of choice in large MH. [ Ophthalmic Surg Lasers Imaging Retina . 2018;49:236–240.]