Author reply

We are pleased with the expressed interest in our work and appreciate the comments of Drs Mamalis and Edelhauser. This rabbit study was undertaken as part of the Food and Drug Administration's Proactive Toxic Anterior Segment Syndrome (TASS) program to investigate whether enzymatic detergents could be a cause of TASS when used as directed in cleaning reusable ophthalmic instruments. Although we did not perform specular microscopy or histologic examination of the corneal tissue, we did evaluate the intraocular response in vivo to detergent exposure. We first generated a dose–response curve to assess the inflammatory responses to different doses of 2 enzymatic detergents. Second, we determined the maximum dose to which the eye would likely be exposed during cataract surgery from using inappropriately cleaned cannulated instruments.