Comparison of inverted flap and subretinal aspiration technique in full-thickness macular hole surgery: a randomized controlled study



To compare the inverted flap and the subretinal aspiration technique for full-thickness macular hole (FTMH) surgery.


Forty consecutive eyes with a stage IV FTMH were randomly assigned into 2 treatment groups. After core vitrectomy and perimacular internal limiting membrane (ILM) peeling, in group A, the subretinal remnant macular fluid was aspirated with a 41-G cannula after the air-fluid exchange procedure, while in group B, the technique of an inverted ILM flap was completed. Differences in postoperative best-corrected visual acuity (BCVA) and occurrence of intraoperative or postoperative complications between the 2 groups were evaluated.


All FTMHs were closed after the first surgery with no intraoperative or postoperative complications. In group A, 16 patients (80%) showed improvement of BCVA and 4 (20%) showed stabilization. In group B, 12 patients (60%) had improved BCVA, while 6 (30%) remained stable and 2 (10%) worsened. Postoperative BCVA for group A was significantly better than for group B (p = 0.022).


The surgical techniques had similar rates of closure of FTMH, although BCVA outcomes were significantly better in the subretinal aspiration group.

Post author correction


Article Subject: Vitreo SURG



Claudio Iovino, Giulia Caminiti, Mario Miccoli, Francesco Nasini, Giamberto Casini, Enrico Peiretti

Article History


Financial support: No financial support was received for this submission.
Conflict of interest: None of the authors has conflict of interest with this submission.

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  • Eye Clinic, Department of Surgical Science, University of Cagliari, Cagliari - Italy
  • Department of Clinical and Experimental Medicine, University of Pisa, Pisa - Italy
  • Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa - Italy

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