The (Flip and Fix) Internal Limiting Flap Technique Versus the Classic Temporal Flap for Macular Hole Repair

We conducted a prospective randomized comparative interventional study in which we enrolled patients older than 50 years with idiopathic macular holes who presented to (Removed in the blinded version of manuscript) in the period between February 2021 and February 2022. Patients with previous macular surgeries and those with any other significant macular pathologies e.g., diabetic macular oedema, myopic maculopathy, choroidal neovascular membrane, or macula-off retinal detachment were excluded.

The study protocol was reviewed and approved by the Ethics Committee of (Removed in the blinded version of manuscript). All patients signed an informed consent after explaining the procedures. The study was conducted in accordance with the tenets of the Declaration of Helsinki.

For all the patients, a retina consultant (I. A.) masked to the procedure that will be done for the patient conducted a comprehensive ophthalmic examination, including best-corrected visual acuity (BCVA) (measured using the Snellen's chart and then converted to the LogMAR for the statistical analysis), slit-lamp examination, and fundus examination.

All the patients had a pre-operative macular OCT scan done. The scans were assessed by the masked retina consultant (I. A.) to confirm the diagnosis and to measure the minimum MH diameter.

The included patients were randomized by a research nurse on a 1:1 basis using the closed envelope technique to have either the new (Flip and fix) technique (Group A) or the PFCL assisted temporal inverted ILM flap technique (Group B).