.webp&w=384&q=75){kind=logo}
Loading, please wait...
Loading, please wait...
Large full-thickness macular holes can be difficult to close successfully with conventional internal limiting membrane (ILM) peeling alone. Randomized evidence has evaluated inverted ILM flap techniques, in which a remnant of peeled ILM is positioned over the hole to provide a scaffold for tissue remodeling. One randomized-control trial compared conventional ILM peeling with an inverted flap in large idiopathic macular holes and reported numerically higher anatomic closure with the flap technique. Other randomized work has shown that once an inverted flap is created, extensive manipulation of the flap may not be necessary to achieve high closure rates. For vitreoretinal surgeons, these data support the concept of matching the surgical technique to hole size and chronicity rather than treating all macular holes identically. The procedure also introduces technical considerations including preservation of the flap, avoidance of excessive retinal trauma, and management of the postoperative gas and positioning protocol. While the evidence is not uniformly definitive for every macular-hole phenotype, inverted ILM strategies have become an important option for large or difficult holes, especially when conventional peeling is considered less likely to provide reliable closure.
Read summarized clinical updates, watch expert medical content, and earn CME certifications right from your smartphone.
Open your smartphone camera to scan and install.
Large full-thickness macular holes can be difficult to close successfully with conventional internal limiting membrane (ILM) peeling alone. Randomized evidence has evaluated inverted ILM flap techniques, in which a remnant of peeled ILM is positioned over the hole to provide a scaffold for tissue remodeling. One randomized-control trial compared conventional ILM peeling with an inverted flap in large idiopathic macular holes and reported numerically higher anatomic closure with the flap technique. Other randomized work has shown that once an inverted flap is created, extensive manipulation of the flap may not be necessary to achieve high closure rates. For vitreoretinal surgeons, these data support the concept of matching the surgical technique to hole size and chronicity rather than treating all macular holes identically. The procedure also introduces technical considerations including preservation of the flap, avoidance of excessive retinal trauma, and management of the postoperative gas and positioning protocol. While the evidence is not uniformly definitive for every macular-hole phenotype, inverted ILM strategies have become an important option for large or difficult holes, especially when conventional peeling is considered less likely to provide reliable closure.
Today
The phase 3 ACACIA-HCM trial reveals that aficamten improves cardiac structure, diastolic relaxation, functional capacity, and symptom burden in symptomatic nonobstructive hypertrophic cardiomyopathy, marking a major milestone in targeted myosin inhibition.
6 days back
A clinical study shows that automated breast ultrasound paired with artificial intelligence accurately classifies BIRADS 3-4 lesions, reaching 95% sensitivity and 79% specificity. This diagnostic advance promises to reduce unnecessary core needle biopsies and refine clinical workflows in breast imaging.
3 weeks back
Researchers have engineered freestanding hierarchical-porous BCZT thin films that resist cracking and enhance ultrasonic energy harvesting in soft tissue. Achieving high piezoelectric output and acoustic matching, this lead-free material offers transformative potential for implantable bioelectronics.
6 days back
A novel pathology-adaptive surface engineering strategy uses functionalized plasma polymer coatings to selectively modulate AGE adsorption, reducing oxidative stress and restoring bone formation in diabetic and aging microenvironments.
3 weeks back
A breakthrough study identifies the Klotho/PKCα/CUX1/SPARC/TGFβ-RII axis as a critical driver of podocyte mitochondrial injury and ferroptosis in diabetic kidney disease, unveiling promising molecular targets to halt renal disease progression.
6 days back
