The principle of the surgical method was the same as reported previously.3 Anesthesia was achieved with instillation of several drops of oxybuprocaine hydrochloride, 0.4%. The cataract was removed by phacoemulsification through a 3.2-mm limbal incision. After meticulous removal of the cortex and polishing of the posterior capsule, the anterior chamber was filled with viscoelastic material and the E-ring was injected into the capsule through the injector. A soft IOL then was implanted into the capsular bag. Using forceps, the IOL loops were fixed into the inner groove of the E-ring under direct observation through an operating microscope. Finally, the viscoelastic material was removed. No sutures were placed. The eye patch was removed the next day. One of us, Tsutomu Hara, performed the procedure in the first 5 cases in group 1 and one of us, Takeshi Hara, performed the procedure in the rest of the cases. The mean (SD) surgical time (including positioning of the lid speculum) in group 1 was 22.4 (5.62) minutes (range, 14-34 minutes) in the E-ring eyes and 8.4 (2.59) minutes (range, 6-16 minutes) in the control eyes. In group 2, after the surgeon became adept at performing the procedure, the surgical time decreased to 13.7 (4.78) minutes (range, 7-21 minutes) in the E-ring eyes and increased to 11.5 (4.26) minutes (range, 7-21 minutes) in the control eyes. All surgeries were transmitted simultaneously to the patients' families in the observation room accompanied by a real-time explanation provided by the surgeon.8 The postoperative care was the same as reported previously.3 The eyes with an E-ring were treated with steroid uptake (methylprednisolone, 4 mg/tablet), 4 tablets/d for 2 days starting 1 day preoperatively, 6 tablets/d for the following 2 days, 4 tablets/d for 3 days, 2 tablets/d for 3 days, 1 tablet/d for 3 days, and then treatment was stopped. A total of 164 mg over 13 days was administered. During the preliminary trial, eye drops and oral nonsteroidal anti-inflammatory drugs were used, but the effect was less than that of a steroid.