Sir,

We appreciate Dean et al's1 interests in our previous article regarding the elevated intraocular pressure (IOP) on the first postoperative day following resident-performed cataract surgery.2 Dean et al's study is so interesting as it shows the postoperative IOP change early after planned sutureless extracapsular cataract extraction (ECCE). Only 22 of 1111 total cases (2.0%) were a planned ECCE in our database. In 22 ECCE cases, mean age was 71.4±17.0 years and 54.5% were male. Seven had diabeties, one had pseudo-exfoliation, and two had glaucoma with topical anti-glaucoma medication. No case was complicated with posterior capsular tear. The preoperative IOP was 15.5±3.8 mm Hg and postoperative day 1 IOP was 20.0±8.4 mm Hg. The postoperative day 1 IOP significantly increased compared with the preoperative IOP (paired t-test, P=0.02), which was consistent with Dean et al's outcome. In all, 31.8% had IOP ≥23 mm Hg and 28.1% had IOP >30 mm Hg. However, there were several differences between the two studies. First, the incision wound was secured by several nylon sutures in our ECCE cases. Second, the postoperative IOP was measured with the Goldmann applanation tonometer instead of non-contact tonometer.