Thank you for the comments.
Regretfully, there is a typographical error in Table 1. The numerical values about the planned surgeries were interchanged. The number of eyes for phacoemulsification and extracapsular cataract extraction should be 72 and 15, respectively, in the primary anterior chamber intraocular lens group. The corresponding numbers should be 34 and 23 in the secondary scleral-fixated intraocular lens group.
We agree that preoperative best-corrected visual acuity in the secondary scleral-fixated intraocular lens group would be useful to detect any drop in visual acuity attributable to primary complicated cataract surgery. Unfortunately, we did not have this information in most of our patients who received secondary scleral-fixated intraocular lens. Future prospective studies can help clarify this issue. As for the reasons for choosing primary anterior chamber intraocular lens or secondary scleral-fixated intraocular lens, there are several factors that we would consider. History of uveitis, glaucoma, narrow angle, and peripheral anterior synechiae are relative contraindications to anterior chamber intraocular lens implantation. They were already excluded in the study to avoid any confounding effect. None of our cases had features suggestive of pseudoexfoliation syndrome.
We have performed subgroup analysis for the 2 anterior chamber intraocular lens types used in our study. There were 68 cases with Bausch & Lomb S112UV intraocular lens and 21 with Pharmacia 351C intraocular lens. There were no significant differences between postoperative logMAR best-corrected visual acuity at 1 year (0.32 ± 0.61 vs 0.33 ± 0.22, P = .944) as well as between the postoperative logMAR best-corrected visual acuity at last follow-up (0.70 ± 0.53 vs 0.63 ± 0.53, P = .581) between both intraocular lens types. Moreover, the number of early and late complications was not different between the 2 anterior chamber intraocular lens types ( P = .840 for early complications; P = .808 for late complications).
Postoperatively, we observed macular diseases such as age-related macular degeneration, diabetic macular edema, and epiretinal membrane in 10 and 6 eyes in the primary anterior chamber intraocular lens and secondary scleral-fixated intraocular lens groups, respectively ( P = .504). We also performed multiple linear regression analysis after excluding these 16 eyes. The presence of late complication was the only independent predictor for poor logMAR best-corrected visual acuity at the last follow-up ( P < .001).
We also agree that comparison of endothelial cell loss between primary anterior chamber intraocular lens and secondary scleral-fixated intraocular lens is important. Unfortunately, endothelial cell density measurements were not available in most patients in our study.