Internal Limiting Membrane Closure of Idiopathic Macular Hol
Purpose: To evaluate the efficacy and safety of combined phacoemulsification and 23gauge pars plana vitrectomy with Brilliant blue-G (BBG)-assisted ILM peeling in idiopathic macular hole surgery with closure of the hole by an inverted ILM flap.

Design: Prospective and interventional case series.

Methods: 23 eyes with large (>400 ?m) idiopathic macular hole treated by phacoemulsification with posterior chamber IOL and 23-gauge vitrectomy with BBG-assisted ILM peeling with closure of the hole by inverted flap of ILM. Patients were followed up for the 12 months. Outcomes were evaluated in terms of visual improvement, macular hole closure and complications.

Results: In 22 (95.6%) patients, the macular hole was closed (21 eye with single procedure and one eye with second surgery), and visual improvement occurred in 19 eyes (82.6%). There were no intraoperative complications. Two patients developed post-operative glaucoma which required medication for a few weeks.

Conclusion: Combined phacoemulsification and 23-gauge pars plana vitrectomy with inverted ILM flap technique using BBG stain and SF6 as retinal tamponade provides good anatomic and visual outcomes in cases of large idiopathic macular holes after one operative interference.

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