Abstract

Macular hole (MH) surgery has undergone sea change in recent years. Despite of different techniques being adopted; many a times the MH fails to close even in experienced hands. Out of the known techniques used to tackle failed MHs – free Internal Limiting Membrane (ILM) flap, autologous serum , use of glue, anterior capsular plug, full thickness retinal patch and tucking of ILM into the hole are the common ones. The most dependable method might be surgeons preference. But, ILM tucking technique provides a technically simpler but anatomically and physiologically better treatment option. Not only it covers the hole but also keeps it near water tight to prevent possibility of neurosensory detachment surrounding the hole. Also it provides a scaffold for ingrowth of retinal cells making it possible for reorganisation of the tissue gaining a near normal foveal contour. Hence, ILM tucking can be considered as the suitable modality to tackle failed MHs.