Viscoelastic-Assisted Rescue of Unintended Free Internal Limiting Membrane Flaps During Macular Hole Surgery: A Two-Case Report

Background/Objectives: Manipulation of an internal limiting membrane (ILM) flap can be technically challenging during macular hole (MH) surgery, particularly in highly myopic eyes with fragile ILM. Although ophthalmic viscosurgical devices (OVDs) have been used to stabilize inverted ILM flaps, their use for the rescue of unintended free-floating ILM flaps has been less well described. This study aimed to describe a perfluorocarbon liquid (PFCL)-free, viscoelastic-assisted rescue technique for the capture, transfer, and stabilization of unintended free ILM flaps during MH surgery.