**23. Dragging and peeling**

Peng in 2020 described a procedure called ILM dragging and peeling [116]. Two horizontal ILM strips were removed in the upper and lower quadrant of the macula. An upper ILM flap was created and pulled down towards the edge of the MH to try and reduce the size of the hole using the adhesion between the ILM and underlying retina. A similar procedure was performed by creating a lower ILM flap which was pulled upwards, also try and reduce the size of the hole by a similar mechanism. Once these tangential forces were applied to minimise the hole size a standard circular ILM peel was created. This surgical procedure derives from the belief that MH mobility is critical for MH closure and it may be that in some cases peeling alone may not give enough mobility to the retina [117]. The authors did not report significant complications and MH closure rate was 96.2%.
