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  1. A A Okada2,
  2. T Wakabayashi2
  1. 2Kyorin Eye Center, Kyroin University School of Medicine, Tokyo, Japan
  1. Correspondence to: Annabelle A Okada Kyorin Eye Center, Kyroin University School of Medicine, Tokyo, Japan; aokadapo.iijnet.or.jp

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We appreciate the interest and many comments we have received regarding our recent article.1 In reply to the comments by Dr Vedantham, we acknowledge the paucity of experimental data to prove that accurate placement of corticosteroids into the sub-Tenon’s space provides good drug penetration into the eye. However, the studies to the contrary cited by Vedantham have all used needles to make such “accurate placement,” including the study by Jennings et al,2 which utilised the technique described by Tessler.3 Use of needles represents not only a potential hazard to the eye in terms of accidental globe penetration, but also makes it much more difficult to place any sub-Tenon’s injection under the posterior Tenon’s capsule near the macula and/or around the optic nerve. It has been shown that many injections intended for the sub-Tenon’s space merely end up somewhere in the orbit outside of Tenon’s capsule.4 We believe that our method using a …

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