Sir,

I would like to thank Dr Yuen and his colleagues for their helpful letter. He raises two important points. A transconjunctival local anaesthetic is indeed as effective as transcutaneous with the benefit of being less painful and causing less bruising; it is now my preferred technique. Secondly, to minimise postoperative inflammation and reduce the chance of early punctal restenosis I now routinely ask the patient to apply G Tobradex in a reducing dose for 4 weeks.