Copyright@ Ioana Teodora Tofolean | Biomed J Sci & Tech Res | BJSTR. MS.ID.003892. 17369 Case Report ISSN: 2574 -1241 Internal Limiting Membrane Inverted Flap Technique for Lamellar Macular Hole – Case Report Florian Baltă 1-3 , Ioana Teodora Tofolean* 2,3 and Ramona Barac 1-3 1 Clinical Emergency Eye Hospital, Romania 2 Carol Davila University of Medicine and Pharmacy, Romania 3 Retina Clinic, Ponderas Academic Hospital, Romania *Corresponding author: Ioana Teodora Tofolean, Carol Knappe 63, 010508, Bucharest, Romania DOI: 10.26717/BJSTR.2019.23.003892 Introduction Idiopathic lamellar macular hole is a disorder of the vitreoretinal interface, consisting of disruption in the foveal inner retinal layers without extension to the photoreceptors and the retinal pigment epithelium [1]. Two types of epiretinal membranes are commonly associated with lamellar macular holes, namely the conventional ERM, characterized by traction, and atypical degenerative ERM, a dense proliferation, without tractional properties, that appears thicker on the OCT [2]. Surgical treatment is indicated, among other factors, when there is significant loss of visual acuity and/or severe metamorphopsia [3]. The standard technique encompasses pars plana vitrectomy (PPV), ERM removal, followed by ILM peeling, with the most common serious complication: the development of full thickness macular hole (FTMH) [4]. Inspired by the inverted flap surgical technique for FTMHs first described by Michalewska et al. [5], we propose a similar surgical approach for the treatment of one case of LMH, considering the advantage of minimizing the risk of postoperative FTMH. Methods The present interventional report describes the case of a middle- aged healthy male patient earlier diagnosed with BE ERM, which exhibited a two-year progression to LMH. Because of LE VA drop, a surgical approach was chosen. The surgery was performed using Received: November 26, 2019 Published: December 02, 2019 Citation: Florian Baltă, Ioana Teodora To- folean, Ramona Barac. Internal Limiting Membrane Inverted Flap Technique for Lamellar Macular Hole – Case Report. Bi- omed J Sci & Tech Res 23(3)-2019. BJSTR. MS.ID.003892. Abbreviations: ILM: Internal Limiting Membrane; BE: Both Eyes; VA: Visual Acui- ty, RE: Right Eye; LE: Left Eye; OCT: Clinical and Optical Coherence Tomography; LMH: Lamellar Macular Hole; LHEP: Lamellar Hole Epiretinal Membrane; FTMH: Full Thickness Macular Hole ARTICLE INFO Abstract Objective: To describe one case of idiopathic lamellar macular hole associated with epiretinal membrane (ERM) surgically treated using the internal limiting membrane (ILM) inverted flap technique. Methods: Interventional case report. Results: The patient first presented to our clinic with both eyes (BE) 6/6 visual acuity (VA) two years before the current visit, when being diagnosed with BE epiretinal membrane without any tomographic sign of retinal layers’ disruption. On the current examination, Snellen’s VA was 6/6 in the right eye (RE) and 6/19 in the left eye (LE). Clinical and optical coherence tomography (OCT) appearances were compatible with the diagnosis of BE lamellar macular hole (LMH) and ERM. The patient’s LE was surgically treated with pars plana vitrectomy and internal limiting membrane inverted flap technique. There was rapid improvement of the anatomical and functional features of the LE macula, the LE VA reaching 6/9.5 at one-month visit. Conclusion: This is, to our knowledge, the first case of lamellar hole associated with lamellar hole epiretinal membrane (LHEP) surgically treated using the internal limiting membrane inverted flap technique. Further studies are needed in order to better asses the method’s anatomical, tomographic and visual outcomes and to establish its indications. Keywords: Lamellar Macular Hole; Inverted Flap Technique; Epiretinal Membrane; Pars Plana Vitrectomy