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We appreciate the thoughtful comments of Dr Chynn. Our synthesis of the literature on cataract surgery and intraocular lens implantation was undertaken to examine the nature and the strength of the evidence generated over the past decade regarding the outcomes of modern cataract surgery. We hope that our review of the rigor of published studies promotes the continuous improvement of the quality of future clinical studies of cataract surgery so that physicians will have sound data on which to base their clinical decisions. This is particularly important in a climate in which resource constraints create pressures that might erode the quality of care.Dr Chynn makes the point that every research study is likely to have limitations, including the review we undertook. We agree. Although we attempted to perform masked abstractions of all the articles we reviewed, it is possible that in some instances our reviewers recognized an