Unusual closure of a large traumatic macular hole after an unorthodox pars plana vitrectomy

This retrospective case report describes the closure of a large traumatic macular hole following PPV, posterior hyaloid detachment, and air tamponade despite the inability to perform ILM surgery. An 11-year-old male presented with a full-thickness macular hole following blunt trauma and a BCVA of counting fingers. Serial OCT examination precluded spontaneous closure. The surgery consisted of PPV and induction of posterior hyaloid detachment. All attempts to perform a modified ILM flap technique failed. Air tamponade was used at the end of the surgery. The post-operative OCT images showed U-type closure of the hole. The BCVA improved to 6/60. We recommend a modified ILM flap technique in large full-thickness traumatic macular holes to improve the functional and anatomical outcomes. Despite the inability of ILM surgery, the hole closure described in this report is an unusual finding.