We thank Nai-Wen F for his kind interest in our article. This retrospective study dealt with outcomes of repeat descemetopexy in postcataract surgery Descemet membrane detachment. Concerns regarding the outcomes of this study have been raised, and the authors would be happy to address them.
Successful reattachment of the detached Descemet membrane by means of a repeated procedure was noted not too long after this study. That was precisely why this paper was written. The authors saw the surgeons’ inclination to resort to corneal endothelial transplantation procedures once the Descemet membrane failed to attach by means of a descemetopexy procedure. However, a repeat procedure was found to be successful. The authors believe this was due to either inappropriate volume or insufficient timing of the filling of the intracameral gas at the initial procedure. The authors have earlier proved that usage of either room air or 14% isoexpansile perfluoropropane (C3F8) provides similar anatomic outcomes. The mean interval between the cataract surgery and the first descemetopexy procedure was 7.07 ± 4.23 days.
Optical coherence tomography of the detached Descemet membrane was performed in only a few cases in which there were doubts regarding the orientation of the Descemet tear. In these cases, the detached Descemet membrane was found not to have rolls or curls. The authors, however, agree that the presence of rolls or curls would be more likely to require multiple interventions.
The relationship between Descemet membrane detachment and the pre-cataract-surgery endothelial status of the patients was not studied in this research. Although it would be interesting to examine this in a prospective study, the relative paucity of Descemet membrane detachment as a post-cataract-surgery complication would make it really difficult.