Author reply

We are grateful to Spratt et al for their interest in our article, and for allowing us the opportunity to further elaborate on our study. We did observe an apparent decrease in the perceived extent of peripheral anterior synechiae (PAS) after lens extraction in these eyes with primary angle-closure glaucoma (PACG), even though no deliberate synechialysis was attempted during lens extraction. We believe this may be partly owing to an overestimation of the extent of PAS before lens extraction in these PACG eyes with very shallow anterior chamber, and partly owing to some unintended synechialysis during the phacoemulsification. The latter might have occurred during the expansion of the anterior chamber with viscoelastic injection. In fact, the phenomenon of a decrease in perceived PAS after lens extraction alone was observed in our previous clinical studies on PACG eyes with coexisting cataract as well.