Surgical management of idiopathic macular hole (IMH) is a hot topic in the field of fundus disease, and its classical surgery is internal limiting membrane peeling.In recent years, many researchers explored inverted internal limiting membrane flap technique for IMH.However, how large the IMH is necessary for inverted internal limiting membrane flap technique? Does the inverted internal limiting membrane flap technique have more advantages in operating procedure, anatomical and functional recovery of IMH in comparison with internal limiting membrane peeling? Our clinical researches and relative literature showed that it is better to use inverted internal limiting membrane flap technique for >550 μm IMH.There is still no available evidence showed inverted internal limiting membrane flap technique is of more benefit to the anatomical repair and functional restoration in comparison with internal limiting membrane peeling for IMH.Some viewpoints in this field are open to question.

Macular hole, idiopathic; Macular hole/surgery; Internal limiting membrane