Sir,We read with interest the article titled "Primary and secondary implantation of scleral fixated intraocular lens (SFIOL) in adult patients" by Zuleyha Yalniz-Akkaya et al.1We congratulate the authors for sharing their large series of 96 patients who underwent SFIOL in their center and reporting the outcomes and complications.We made the following observations while reading this article:--A. Postoperative complications such as glaucoma and cystoid macular edema (CME) may occur secondary to both penetrating keratoplasty (PK) and SFIOL.2 Since all the patients who underwent a combined PK and SFIOL were in the secondary group, this may lead to error when comparing the incidence of these two postoperative complications between primary and secondary groups. Perhaps the groups would have been more comparable if the patients undergoing a combined PK and SFIOL procedure were excluded from the secondary groupB. The five eyes with a history of penetrating ocular injury who underwent a SFIOL were all included in the secondary group; however, there is no mention of coexisting trauma to other parts of the eye, especially corneal opacity secondary to corneal tear repair and posterior segment pathology, which may also have a bearing on the final corrected distance visual acuity (CDVA). This may also lead to a bias in comparing the final visual outcome between the primary and secondary SFIOL groups. Likely, the exclusion of these five eyes would have made the two groups more comparable.