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Efficacy of the Perfluoro-N-Octane-Assisted Single-Layered Inverted Internal Limiting Membrane Flap Technique for Large Macular Holes

Purpose: The aim of this study was to evaluate the efficacy of the perfluoro-n-octane-assisted single-layered inverted internal limiting membrane (ILM) flap for large macular holes (MHs). Methods: We reviewed idiopathic MHs >400 μm. The patients were divided into ILM peeling (group P, 51 eyes) and ILM flap (group F, 41 eyes). Closure of MHs, best-corrected visual acuity (BCVA), and postoperative optical coherence tomography findings were analyzed. Results: MH closure was achieved in 88.2% in group P and in 100% in group F (p = 0.032). SF6 and air was used most frequently in groups P and F, respectively. Both had a significant improvement in BCVA, which was better in group F until 3 months, but not at 6 months. At 6 months, the ellipsoid zone and external limiting membrane were restored with no significant difference. Conclusion: The single-layered inverted ILM flap was better for the closure of large MHs than ILM peeling, without using long-acting gas that prevents early rehabilitation.