Sir,
Many thanks to Özyol and Özyol1 for their interest in our article.
Intraocular lens implantation is facilitated by the use of ophthalmic viscosurgical devices (OVDs) that possess moderate viscosity at medium shear rate.2 We agree that the use of OVDs can be associated with complications if proper removal is not done; however, their use during implantation of intraocular lens (IOL) makes the process smooth and safe.
‘Hydro-visco-implantation technique' may be a good approach to maintain the wound integrity and size after IOL implantation as suggested by the authors.3 Presence of both OVD and balanced saline solution in anterior chamber produces a duality in the chamber that can result in poor visibility and shallowing of anterior chamber during IOL insertion. Irrigation can also lead to wash out of the OVDs as stated by Özyol and Özyol in their study, which can cause anterior chamber instability.3
It would have been really nice if Özyol and Özyol had done measurement of incision size and size of side port before and after IOL implantation. Anterior segment optical coherence tomography (ASOCT) study in such patients would really tell about the wound integrity and changes that occur both at the main incision site as well as the side ports where irrigation cannula is placed.
Hence we suggest the use of ASOCT to study the wound architecture after the technique described by Özyol and Özyol, which would further certify the safety of the technique.
The authors declare no conflict of interest.
References
- Özyol E, Özyol P. A different approach for manual foldable IOL injection for keeping wound size and integrity. Eye (Lond) 2015;29:446–447. doi: 10.1038/eye.2014.305. [DOI] [PMC free article] [PubMed] [Google Scholar]
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- Özyol E, Özyol P. Hydro-visco-implantation technique for wound-assisted foldable intraocular lens implantation during microincision cataract surgery. J Clin Res Ophthalmol. 2014;1:103. [Google Scholar]