Macular Hole surgery through common but sometimes tricky in certain cases with large hole and associated with epiretinal membranes. It demands certain degrees of surgical skills and expertise. In this surgical video, we describe 3 different macular hole surgeries with different challenges. First case was a large FTMH 1050 micron with very poor pre-operative vision, managed with inverted flap technique with post operative improvement of vision. Second case was a previously failed macular hole, managed with ILM free flap taken from peripheral retina. In third case the patient had ERM with FTMH; inverted ILM flap was planned but could not be achieved. It was then tackled with free floating flap after eventful ILM peeling.
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