Sir,
We thank Lim et al1 for their constructive comments and concur that a larger, prospectively designed study is certainly required. Our data were retrospective, and despite including a significant number of patients (1407) it was never our intention to statistically prove that omitting a shield confers a safety advantage over shielding. The data were collected and published to illustrate that not shielding in our practice over the last 12 months conferred no disadvantage. We hoped to stimulate discussion as to why routine shielding still occurs despite advances in surgical technique with some interesting comparative data.
We also would like to reiterate the differences between shields and patches. Patches protect the ocular surface against particulates and provide visual occlusion. Their role in the immediate postoperative period has both supportive (as above) and derisory2 evidence. Shields are supplied to protect surgical wounds and are commonly prescribed for up to 3 weeks following cataract surgery at night. A small group of our patients were randomly selected and questioned about their experiences of shields. Comparing these shield-related responses to studies on patching is not justified.
The author declares no conflict of interest.
References
- Lim LW, Chew MC, Tan CS. Postoperative eye protection after cataract surgery. Eye. 2012;26 (8:1152–1153. doi: 10.1038/eye.2012.95. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mayer S, Wirbelauer C, Haberle H, Altmeyer M, Pham DT. Evaluation of eye patching after cataract surgery in topical anaesthesia. Klin Monbl Augenheilkd. 2005;222 (1:41–45. doi: 10.1055/s-2004-813826. [DOI] [PubMed] [Google Scholar]