Modified packing technique in large traumatic macular holes

Autologous internal limiting membrane (ILM) flap techniques have been demonstrated to increase the incidence of successful closure in large traumatic macular holes (TMHs). Different ILM flap manipulation and placement approaches have been described, including the non-inverted free ILM flap and the inverted ILM flap techniques. The usage of viscoelastic fluids and perfluorocarbon heavy liquids has been described to achieve proper ILM flap positioning in idiopathic macular holes(MH). We describe a modified ILM packing technique for the treatment of large TMH entitled “fill in the hole” and we present the anatomical and visual results in two cases. We also present a step-by-step video describing the “fill in the hole” technique.