Abstract: Objective To evaluate the efficacy and safety of vitrectomy combined with inverted internal limiting membrane flap technique for treating high myopic macular hole (HMMH) without retinoschisis. Design Retrospective case series. Participants A total of 25 patients (25 eyes) with HMMH without retinoschisis who were treated in the Department of Ophthalmology, Beijing Xuanwu Hospital from February 2019 to May 2022 were included. The mean axial length was (28.38±0.93) mm, and the mean diopter of refractive error was (-10.96±2.31) D. Methods All patients underwent vitrectomy combined with inverted internal limiting membrane flap surgery. Best corrected visual acuity (BCVA) (LogMAR) and morphological results from optical coherence tomography (OCT) were collected preoperatively and at 1, 3, and 6 months postoperatively. Macular hole closure was assessed using OCT. Main Outcome Measures BCVA, number and proportion of eyes with macular hole closure, and incidence of postoperative complications. Results BCVA improved significantly from baseline (1.39±0.62) LogMAR to (1.06±0.24) LogMAR at 1 month postoperatively (Z=-3.930, P<0.001), (1.01±0.26) LogMAR at 3 months (Z=-4.025, P<0.001), and (0.99±0.27) LogMAR at 6 months (Z=-4.023, P<0.001). The number of eyes with HMMH closure at 1, 3, and 6 months postoperatively was 21 (84%), 22 (88%), and 22 (88%), respectively. No postoperative complications were observed in any patients. Conclusion The follow-up results over a period of 6 months indicate that vitrectomy combined with inverted internal limiting membrane flap technique can improve BCVA and promote HMMH closure, representing an effective and safe treatment for HMMH.

Key words:  Macular hole/surgery, Internal limiting membrane, High myopia