Sir,

We thank Kumar et al for their interest in our article. In answer to their points: first, the IOL's were all in the sulcus and we appreciate there can be problems from this later. However, to date there have been no complications seen by, or reported to us, in the treatment group.

Second, silicone lenses were used. Most of the patients had a full vitrectomy including peel of the posterior hyaloid and would not therefore be expected to develop retinal detachment (RD) in the future. Even if they did, very few patients require silicone oil in the treatment of RD—so we consider this of low risk. However, there is no objection to the use of an acrylic lens in this operation if preferred by the surgeon.

Finally, in our experience, failing to remove the posterior hyaloid in the few young patients has not resulted in epiretinal membrane formation. In fact the main risk in this group would be RD later when the posterior hyaloid finally spontaneously separates.