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No PFCL, gas, or air tamponade was used, and no face-down positioning was required. Minimum follow-up was 3 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-six patients, fifteen women (57.7%) and eleven men (42.3%) were included in the study. The mean age was 72.2\u2009\u00b1\u20098.5 years (range 51\u201388). Mean minimum linear diameter (MLD) was 341.2\u2009\u00b1\u2009191.8\u00a0\u03bcm (range 50\u2013775\u00a0\u03bcm); 9 holes were small (&lt;\u2009250\u00a0\u03bcm), 10 were medium (250\u2013400\u00a0\u03bcm), and 7 were large (&gt;\u2009400\u00a0\u03bcm). The mean duration of symptoms was 4.85\u2009\u00b1\u20093.34 months. Primary anatomical closure after one procedure occurred in 25\/26 cases (96.2% primary success). The mean follow-up was 4.77\u2009\u00b1\u20091.37 months. Best-corrected visual acuity improved significantly (from 1.12 logMAR, to 0.46 logMAR,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Two intraoperative retinal tears occurred during posterior vitreous detachment (PVD) induction and were treated with endolaser; no postoperative retinal detachment, hypotony, or endophthalmitis occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this prospective pilot series, a PFCL-free, tamponade\/air-free, viscoelastic-assisted superior ILM flap technique was associated with a high primary closure rate without postoperative positioning. Larger comparative studies with longer follow-up are needed to assess generalizability and complication rates, particularly for large macular holes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00417-026-07410-1","type":"journal-article","created":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T04:13:28Z","timestamp":1784952808000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tamponade-free superior ILM flap for idiopathic macular hole repair: a pilot study"],"prefix":"10.1007","author":[{"given":"Androniki","family":"Zampogianni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stergios","family":"Ntikos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Moraitis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stratos","family":"Gotzaridis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilias","family":"Georgalas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Kymionis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros","family":"Petrou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"issue":"3","key":"7410_CR1","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/j.ophtha.2012.09.003","volume":"120","author":"TL Jackson","year":"2013","unstructured":"Jackson TL, Donachie PHJ, Sparrow JM, Johnston RL (2013) United Kingdom National Ophthalmology Database study of vitreoretinal surgery: report 2, macular hole. 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