Enhancing Inverted Internal Limiting Membrane Flap Stability in Macular Hole Retinal Detachment by the “Viscoelastic Agent Pool” Technique

Purpose: To evaluate the surgical, anatomical, and functional results of “viscoelastic agent pool” technique–assisted stability of inverted internal limiting membrane flap in macular hole retinal detachment. Methods: The innovative surgical technique was performed on 10 patients with macular hole retinal detachment. The primary outcomes included best-corrected visual acuity after surgery, rate of closure of macular hole, retinal reattachment, and occurrence of complications. Results: The mean age of the individuals was 67.70 ± 8.75 (range, 55–84) years; mean axial length, 29.34 ± 1.53 (range, 27.10–30.93) mm; mean corrected MH diameter, 685.30± 345.65 (range, 172–1,325) µ m; and average follow-up period, 6.01 ± 1.71 (range, 3.10–8.4) months. In 6 eyes (60%), the postoperative best-corrected visual acuity showed improvement. All patients had macular hole closure, and the retinal reattachment rate was 100%. No postoperative complications were noted. Conclusion: The "viscoelastic agent pool" technique, an innovative surgical approach designed to enhance the stability of the internal limiting membrane flap, serves as an effective adjunctive procedure for the inverted internal limiting membrane flap technique. It presents a viable option for patients with macular hole retinal detachment.