Dr. AJAY AURORA

Abstract

We describe ten eyes with large macular holes with or without irregular edges that underwent multiple leaf inverted ILM (Internal Limiting Membrane) flaps of differential sizes reposed on the macular hole like cabbage leaves ensuring a hook-and-loop fastener closure of the inverted ILM flaps without the need to stuff ILM into the macular hole. The sequential OCT and OCTA images were done to understand the macular hole closure.

All holes had a type1 closure with improvement of VA by 2-4 lines .

The differential sizing of the “cabbage” leaves may aid in appropriate edge movement of the macular hole ensuring consistent type 1 closure obviating the need for heroic surgeries.The mechanism of cabbage closure is based on the Electron microscopic characteristics of ILM.