Sir,

We thank Morsman for his comments and interest in our recently published article.1

Concerning the statistical analysis, we do not understand to which results the author referred to. There are no such comparisons in our article. We made a global comparison of postoperative endophthalmitis (POE) incidences between the five types of material and comparisons between one type of material (PMMA) and each of the other four types.

The choice of the two periods we made may be discussed. The choice of two periods of equal length seems to be a good option because it does not depend on observed data. We have taken another criterion corresponding to the change in surgery techniques.

Concerning the influence of learning curves, we agree with Dr Morsman's comment, more especially as the cataract extraction technique seems to have no influence on the incidence of POE as well in our series as in the literature. Nevertheless, we can note that in the recent ESCRS multicenter prospective study2 more experienced surgeons were more likely to be associated with endophthalmitis cases. We believe that this may suggest that the experienced surgeons are more likely to be involved in more complicated cases, including those that result in endophthalmitis. Nonetheless, this proves that reality is probably more complex. Finally, we would like to highlight that our data can exclude the influence of incision site and of wound's size, as among the rigid IOLs group, we demonstrated a significant higher risk of POE with PMMA than with heparinized PMMA.