(SWAP) shows significantly decreased sensitivity in eyes with yellow-tinted intraocular lenses (IOLs) compared with eyes with clear IOLs, whereas standard automated perimetry failed to show the difference. SWAP is not easy to perform, especially for older patients. We agree that the Swedish interactive threshold algorithm (SITA) with SWAP may be a better choice than the full-threshold strategy with SWAP because of its advantages with regard to shorter test duration. 2 However, we could not perform SWAP with SITA because the SWAP with SITA mode was not available at our institu- tion. Although we agree with Dr Ho’s comment, we do not believe that use of the full-threshold strategy with SWAP could affect the study results significantly, because we did not assess serial SWAP changes in the same location and we attempted to obtain the best result of SWAP to overcome patients’ poor performances or long-term vari- ability problems. Furthermore, a recent study demonstrated that sensitivities did not differ between SITA and full- threshold algorithms, despite several advantages associated with SWAP using SITA. 3 As suggested by Dr Ho, analysis of the intertest variabil- ity in SWAP could be another option. In several patients whose visual field results were serially reliable, we found that the intertest difference of the results tended to be greater in eyes with yellow-tinted IOLs. In our study, however, we used several strategies to overcome variability problems. First, we performed standard automated perim- etry before SWAP for all subjects with the expectation that the patient would become more familiar with the visual field test through a learning effect. Second, we attempted to obtain the most reliable result through repeated testing. We also agree with Dr Ho’s comment that the statistical significance may not always retain a clinically meaningful difference, especially when the extent or magnitude of mean deviation and pattern standard deviation variability is not documented fully. However, we added the glaucoma hemifield test score as a measured outcome, which has not been attempted previously. Glaucoma hemifield test reports from SWAP also showed significant differences between eyes with yellow-tinted and clear IOLs, whereas those from standard automated perimetry did not. A recent study by Wirtitsch and associates demonstrated that foveal thresh- old was significantly lower in eyes with yellow-tinted IOLs in SWAP. 4 Comparisons using several different types of indices could support and reinforce the result that yellow IOLs may affect SWAP. Further evaluation regarding the effect of yellow-tinted IOLs on the variability of SWAP may be valuable. We thank Dr Ho for his insightful suggestions, which we had not considered. SUN WOONG KIM SUN YOUNG JANG Bucheon, Korea REFERENCES 1. Jang SY, Ohn YH, Kim SW. Effect of yellow-tinted intraoc- ular lenses on short wavelength automated perimetry. Am J Ophthalmol 2010;150(2):243–247. 2. Bengtsson B, Heijl A. Normal intersubject threshold variabil- ity and normal limits of the SITA SWAP and Full threshold SWAP perimetric programs. Invest Ophthalmol Vis Sci 2003; 44(11):5029 –5034. 3. Ng M, Racette L, Pascual JP, et al. Comparing the full- threshold and Swedish interactive thresholding algorithms for short-wavelength automated perimetry. Invest Ophthalmol Vis Sci 2009;50(4):1726 –1733. 4. Wirtitsch MG, Schmidinger G, Prskavec M, et al. Influence of blue-light-filtering intraocular lenses on color perception and contrast acuity. Ophthalmology 2009;116(1):39 – 45. Amniotic Membrane Grafting in the Management of Acute Toxic Epidermal Necrolysis/Stevens Johnson Syndrome EDITOR: WE READ WITH INTEREST THE ARTICLE BY SHAMMAS AND associates, which described the usefulness of the appli- cation of amniotic membrane graft along with intensive topical steroids in cases of acute toxic epidermal necroly- sis/Stevens Johnson syndrome. 1 This report addresses the issue of management of acute toxic epidermal necrolysis/ Stevens Johnson syndrome, for which there is no stan- dardized management protocol in literature. We offer a few comments. The results of this study are in agreement with recently published reports, and this case series demonstrates that amniotic membrane graft performed in the acute phase of toxic epidermal necrolysis/Stevens Johnson syndrome is vital to prevent sight-threatening cicatricial complications as the disease progresses. 2,3 These authors have not mentioned the details of sys- temic treatment. As noted by Araki and associates, use of systemic pulse corticosteroids during the early period of 1 to 2 weeks has a beneficial effect. 4 So if corticosteroids were used, the effect of amniotic membrane graft may be masked. It is not clear whether all the patients were consecutive or if there were other methods of management. If other methods were present, a comparison between the different treatment groups would have validated the authors’ point further. The authors should have mentioned the time elapsed between application and removal of the ProKera device CORRESPONDENCE VOL. 151,NO. 2 381