W e read with great interest the article titled “Seven-Year Clinical Outcomes and Optical Quality of Implantable Collamer Lens Implantation Versus KLEx for Myopia Correction” by Cheng et al. The authors conducted a 7-year comparative study of the contralateral eye to compare the long-term clinical outcomes of an implantable collamer lens (ICL) compared to keratorefractive lenticule extraction (KLEx) in patients with anisometropic eyes. The authors used a within-patient design to show that both treatments were safe and effective. In addition, the authors examined whether patients’ refractive outcomes remained stable over time and therefore whether their visual and optical quality was maintained within the bounds of what is acceptable for patients through long-term follow up.
We wish to highlight a discrepancy related to how endothelial cell density (ECD) loss was documented in the manuscript. ECD loss percentages were determined using the average ECD before and after surgery; accurate documentation of both will be necessary to accurately interpret the long-term endothelial outcomes in patients. The discrepancies that we have found between the numbers listed in the tables as well as the percentage of loss of ECD that is stated in the body of the text warrant additional explanation as well as revision.
The use of the preoperative mean ECD values listed in Table 1 (KLEx: 2960.40 cells/mm²; ICL: 2954.64 cells/mm²), along with the 7-year postoperative ECD values (KLEx: 2576.92 cells/mm²; ICL: 2654.96 cells/mm²) results in a recalculation of endothelial cell loss of 12.95% for the KLEx group and 10.14% for the ICL group. This recalculation does not match the loss rate stated in the Results section (7.99% for KLEx; 12.38% for ICL), thereby creating an error that should be addressed through proper documentation of the calculation methodology used and correction of the reported percentage of loss.
Improvement of the accuracy, transparency, and internal coherence of the paper, without changing its conclusions, can be achieved by properly documenting the calculation method used and by correcting the percentage of loss as reported in both the Results and Discussion sections.
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