As was acknowledged by Nakasato et al1 in their paper, due to the small number of patients studied, their newly described techniques to remove dislocated lens fragments during the cataract surgery should not be used as a routine alternative to the traditional pars plana vitrectomy. Their method may be considered as an emergent alternative for those cataract surgeons who have limited retinal surgery experiences. It can also be considered on occasions where the retinal surgical equipment or instruments are unavailable. In addition to the above limitations, we have several other concerns regarding the reported indications and surgical techniques.

1. Fragment size: Since most of the nuclear fragments drop suddenly during the procedure, it is very difficult for the operator to accurately assess the size of …