Inverted epiretinal proliferation flap with internal limiting membrane preservation for myopic macular hole retinal detachment: a case report

In this case report, we describe a 52-year-old woman with high myopia presented with a macular hole retinal detachment for 5 months. Fundus examination showed a full-thickness macular hole with localized retinal detachment, accompanied by both superior and inferior posterior scleral staphylomas. Spectral-domain optical coherence tomography confirmed a large full-thickness macular hole with associated epiretinal proliferation. She underwent 27-gauge vitrectomy using an inverted epiretinal proliferation flap technique without internal limiting membrane peeling, followed by gas tamponade. Postoperatively, the retina was reattached and the macular hole was closed. Best-corrected visual acuity improved from hand motions to 20/200. At the 12-month final follow-up, BCVA remained stable at 20/200, with no evidence of hole reopening or recurrent retinal detachment. This case demonstrates that inverted epiretinal proliferation (ERP) flap with internal limiting membrane (ILM) preservation may represent a feasible tissue-preserving reconstructive strategy for selected patients with myopic macular hole retinal detachment (MHRD) when sufficient ERP is present.