Use of Cabbage Leaf Inverted Flap Technique in the Management of a Stage IV Full-Thickness Macular Hole

<b>Background:</b> The purpose of this study was to evaluate the anatomical and visual outcomes of patients with stage IV full-thickness macular holes (FTMHs) treated by the cabbage leaf inverted internal limiting membrane (ILM) flap technique. <b>Methods:</b> We conducted a retrospective study, enrolling patients with stage IV FTMH operated by a single surgeon. Six patients with FTMH and no other known ocular comorbidities were included in the study. <b>Results:</b> Four patients (66.6%) were female, two were male. The median age was 71. The average duration of symptoms before surgery was 10.5 months (6-24 months). The mean preoperative minimum hole diameter was 480 μm (337-602), and the mean basal hole size was 1208 μm (703-1748). The mean preoperative BCVA was 0.63 LogMAR. Postoperatively, the BCVA improved in 5 (83.3%) patients and remained the same in 1 (16.7%). The mean postoperative BCVA was 0.42 LogMAR (0.0-0.70). The FTMH has closed in all cases (100%). At the follow-up examination three months after the surgery, we observed complete closure of the FTMH with the restoration of retinal layers. <b>Conclusions:</b> This approach resulted in a complete closure of FTMH with significant visual acuity improvement. The technique could represent the surgical procedure of choice in the management of stage IV FTMH.