Sir,

We thank Drs Singh and Stewart for their interest in our paper.

We agree that time is definitely the essence for operating on an unstable super-temporal macula on rhegmatogenous retinal detachment. The objective of our paper1 was to advocate the routine use of the operating microscope when it is available for buckling surgery. Not having access to the operating microscope in a scenario as described will definitely make it difficult to achieve the objective as suggested in our paper. In this situation, a loupe would be a superior alternative to surgery performed with the naked eye.

We assume that the authors probably mean to say that, with the universal adoption of phacoemulsification, cataract surgery trainee surgeons do not get adequate practice in suturing techniques.

This is quite true and makes it a compelling argument for suturing under the operating microscope, as there is greater stereopsis and magnification and less likelihood for scleral perforation, particularly for trainee surgeons. Ambidexterity can be achieved with practice over a period of time under an operating microscope.

Back problems related to posture adopted during surgery are due to bending and leaning over the operating site when standing. This is again minimal with the use of operating microscope, required only during break localization and cryopexy.

We strongly believe that using the microscope will result in better trained, more dexterous vitreoretinal surgeons, with less risk of inadvertent scleral perforation during surgery and less prone to back problems in later life.