Explantation

The "cold laser" has been described . . . the fine print explaining that its temperature is near that of the surface of the sun. A simple nonsurgical method to "clean the membrane" has been marketed . .. with the careful use of the term capsulotomy for insurance reports. A "completely safe" alternative to surgery has been promoted without proof of the effects of absorbed energy. I was one of the first to see and try the new instruments in Europe shortly after their announcement and to follow the meteoric rise of their application. In the September issue, we saw the first reported clinical study seriously raising the question of safety in the use of the YAG laser for capsulotomy (Knolle GE Jr: Knife versus neodymium:YAG laser posterior capsulotomy: A one-year follow-up. Am Intraocular Implant Soc] 11:448-455, 1985). W e have long been aware of the serious ill effects of the absorption of low-density energy in cases of blunt trauma. Weare now learning of previously unanticipated problems with phototoxicity. Is it also possible that the energy-invasive YAG capsulotomy is not entirely safe and effective? Is it thinkable that the risk of endophthalmitis in surgical discission is more acceptable than the energy-related risks of the YAG? We must applaud Dr. Knolle for his intellectual honesty in recognizing and acting on his perception of the potential problem . I certainly look forward to further sound clinical data on this most important subject.

WEARING GLOVES BETWEEN CASES For the past several years because of the rapid turnover between cataract extraction-intraocular lens implant cases, I have continued to wear the surgical gloves for the five to ten minutes between cases. It was my understanding that this was a better sterile technique than removing the gloves. Before each case, the gloves would be removed and an appropriate scrub pe rformed. Recently, one of the surgical technicians stated that this was not the approved method of sterile technique. Will you please comment if it is best to wear gloves between cases before scrubbing or to take them off after the case is over. Alvan Balent, M.D.

Fort Lauderdale, Florida

EXPLANTATION To the Editor: Please excuse the pedantry, but is "explantation" etymologically correct? None of the dictionaries I have consulted, medical or nonmedical, mention this word. Should we not continue to refer to "IOL removal" until we have decided whether it is in order to add" explant" and "explantation" to the list of words contributed by America to the English language? D.P. Choyce, M.S., F.R.C .S.

David J. Mcintyre, M.D.

Westcliff-on-Sea, England

Bellevue, Washington

In the July 1985 issue, one line of the program (page 404) in "A BASIC Language Computer Program for Intraocular Lens Power Calculations" was printed incorrectly. It should read: 5250 CA=(1336/(AL- H - . 05))-1. 336/«1. 336/(C+F)-(H + .05)/1000))

AM INTRAOCULAR IMPLANT SOC

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