To the Editor.
—The correspondence of McCuen and Klombers1 was timely and helpful. They point out the refractive consequences of vitreous surgery in pseudophakic eyes when temporary or permanent changes in the refractive index of the vitreous cavity are made (ie, with air, gas, or silicone). These refractive consequences may negatively affect the patient's postoperative visual acuity and may make clinical examination and surgical treatment more difficult. For these reasons, the authors recommend that surgeons planning cataract surgery in patients with significant diabetic retinopathy consider using posterior chamber intraocular lenses (IOLs) with an optic diameter of 7 mm, no positioning holes, and a planoconvex configuration.While we certainly agree that a planoconvex posterior chamber lens has optical advantages in the above circumstance compared with a biconvex lens, another, even better option exists. Perhaps for reasons of having to deal with a very complex optical subject in a brief space,
McCartney DL, Guyton DL. The Choice of Posterior Chamber Intraocular Lens Style in Patients With Diabetic Retinopathy. Arch Ophthalmol. 1991;109(5):615. doi:10.1001/archopht.1991.01080050021012
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