In Reply Dr Lempert raises several issues, which we believe are mistaken or do not affect the interpretation of our results. As described,1 only participants at sites with more than 5 enrolled children were eligible for long-term follow-up for logistical reasons, which reduced the proportion of the original cohort that was enrolled in the follow-up study. The 15-year examination was completed by 152 of 188 eligible participants (80.9%). We compared patients who participated in follow-up with those who did not and noted in the article that those who participated had slightly better VA at 2 years than those who did not (20/25 vs 20/32, respectively), which could have resulted in a slight overestimate of VA at age 15 years. In addition, 147 participants in Table 1 noted by Dr Lempert were only those who completed the visit at age 15 years and had VA tested with the electronic Early Treatment Diabetic Retinopathy Study testing protocol (E-ETDRS).2 Five participants had VA tested with a method other than E-ETDRS and were not included in the primary results.