Sir,

We read with great interest the article ‘Comparison of 25- and 23-gauge sutureless microincision vitrectomy surgery in the treatment of various vitreoretinal diseases’ by Nam et al.1 We have some questions and comments to share with the authors.

(1) We do not know how the authors made the main incision for phacoemulsification in those patients who underwent combined cataract surgery and vitrectomy. This is important, as the location and architecture of the main incision might affect the postoperative anterior segment scores and the development of postoperative hypotony.

(2) We are wondering why the postoperative anterior segment score did not include the grading of anterior chamber cells/flares, which is also a very important parameter in evaluating postoperative anterior segment status.2

(3) The authors may consider using the ultrasound biomicroscopy (UBM) to evaluate the sclerotomy sites, as UBM can provide more objective information about the architecture of the sclerotomy sites.3

(4) The authors may need to specify the possible causes and treatments of postoperative hypotony in this study. Knowing what had possibly caused the postoperative hypotony may allow us to evaluate the function of the two different sizes of sclerotomy sites more objectively.

(5) We are curious about how well the air/gas tamponade filled the vitreous cavity in the early postoperative period (eg, 1 day and 1 week postoperatively). The percentage of the air/gas tamponade occupying the vitreous cavity may reflect the ‘self-sealingness’ of the sclerotomy sites. The more the gas that leaks from the sclerotomy sites, the less the percentage of gas that fills the vitreous cavity.

(6) Finally, the authors may also need to specify the method they used to detect wound leakage. It is critical to know whether the method used was appropriate or not, as wound leakage was one critical parameter in evaluating the function of the sclerotomy sites.

Conflict of interest

The authors declare no conflict of interest.