Reply: Postoperative induced myopia in patients with combined vitrectomy and cataract surgery

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patients with epiretinal membranes and macular holes; results of a prospective controlled clinical trial. J Cataract Refract Surg 2008; 34:1754–1760 2. Liesegang TJ, Skuta GL, Cantor LB, eds. Basic and Clinical Science Course. Section 3. Clinical Optics. San Francisco, CA, American Academy of Ophthalmology, 2007–2008 3. Sardar DK, Swanland G-Y, Yow RM, Thomas RJ, Tsin ATC. Optical properties of ocular tissues in the near infrared region. Lasers Med Sci 2007; 22:46–52

unless these vitreoretinal diseases are associated with a pigment epithelial detachment. These findings were confirmed by other studies.2,3 The authors proposed interesting approaches to minimize the postoperative refractive error. We agree that further research is necessary to increase the accuracy of biometry in these patients.dChristiane Isolde Falkner-Radler, MD

REPLY: We agree with the assumption of Mehdizadeh and Nowroozzadeh that replacing the vitreous gel by aqueous might add to the postoperative myopic shift after combined surgery. In our study, all AL measurements were performed using the IOLMaster (Carl Zeiss Meditec), which does not measure to the retinal surface, as ultrasound does.1 We think that using the IOLMaster does not affect the accuracy of AL measurements in patients with an ERM or with macular edema

1. Olson T. Calculation of intraocular lens power: a review. Acta Ophthalmol Scand 2007; 85:472–485 2. Jeoung JW, Chung H, Yu HG. Factors influencing refractive outcomes after combined phacoemulsification and pars plana vitrectomy; results of a prospective study. J Cataract Refract Surg 2007; 33:108–114 3. Kova´cs I, Ferencz M, Nemes J, Somfai G, Salacz G, Re´csa´n Z. Intraocular lens power calculation for combined cataract surgery, vitrectomy and peeling of epiretinal membranes for macular oedema. Acta Ophthalmol Scand 2007; 85:88–91

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J CATARACT REFRACT SURG - VOL 35, MAY 2009