Perfluorocarbon liquid-assisted inverted multilayer internal limiting membrane flaps covering for macular hole retinal detachment in high myopia with axial length ≥30 mm.

AIM: To evaluate the surgical outcomes of the perfluorocarbon liquid (PFCL)-assisted inverted multilayer internal limiting membrane (ILM) flaps covering technique in macular hole retinal detachment (MHRD) in high myopia with axial length (AL) ≥30 mm. METHODS: In this retrospective, interventional, consecutive comparative study, 44 MHRD eyes were divided into two groups: the PFCL-assisted inverted multilayer ILM flaps covering technique group (Group 1, 21 eyes) and the ILM peeling group (Group 2, 23 eyes). The follow-up period was >12mo. Postoperative outcomes, including retinal reattachment, macular hole (MH) closure, and best-corrected visual acuity (BCVA), were assessed. Statistical analysis using the Mann-Whitney U test and Fisher's exact test was conducted to compare differences between groups. RESULTS: There were no statistically significant differences in baseline preoperative clinical characteristics, including age, sex, AL, diopters, duration of symptom, lens status, posterior staphyloma presence and extent of RD. Retinal reattachment rates were higher in Group 1 (90.5%) than in Group 2 (82.6%), without statistical significance (P=0.667). MH closure rates were significantly higher in Group 1 (85.7%) than in Group 2 (17.4%; P<0.001). The Group-1 BCVA (logMAR) improved significantly from 2.13±0.91 preoperatively to 1.21±0.66 postoperatively (P=0.026). The Group 2 BCVA improved significantly from 1.91±0.53 preoperatively to 1.19±0.41 postoperatively (P=0.032). However, there were no significant differences in visual-acuity improvement between groups (P=0.460). CONCLUSION: This technique offers a more effective approach for improving MH closure rates and postoperative visual function in MHRD with AL≥30 mm in high myopia.