Sir, We read with interest the article by Patel and Rahman,1 whose study involved an online survey aimed at members of the Britain & Eire Association of Vitreoretinal Surgeons (BEAVRS) to disclose their experience with endophthalmitis following smaller gauge vitrectomy surgery. Two cases of endophthalmitis following 4944 transconjunctival 23G vitrectomy operations were noted, providing an estimate for the incidence of 1 in 2472. As the authors highlight, this remains an estimate due to the low response rate (31%) and lack of documentary evidence. However, it is reassuring that this study has not revealed a dangerously high rate for this severe complication as sutureless vitrectomy has now become the mainstay in an increasing number of vitreo-retinal centers. Previous studies have differed greatly with respect to the estimated incidence of endophthalmitis following sutureless vitrectomy—exemplified by the study at Wills Eye Hospital2 finding the rate to be more than 12 times higher than that following sutured vitrectomy and contrasting with another American collaborative study3 that recently found no increased rate of endophthalmitis following sutureless surgery. These studies are limited by their retrospective nature and coverage of a relatively small catchment area. In order to establish a more reliable incidence for endophthalmitis following vitrectomy in the United Kingdom, we have currently completed 15 months of prospective, national surveillance (in association with the British Ophthalmic Surveillance Unit, BOSU), and received 18 reports of endophthalmitis following vitrectomy—14 of which meet our case definition. Given that data from the Hospital Episode Statistics disclose that ∼20 000 pars plana vitrectomies are performed each year, this provides an approximate incidence of 1 in 1800 before adjusting for underreporting (yet to be established with the use of validation centers). This framework that BOSU helps to provide is well suited to rare complications providing prospective surveillance across a large geographical area. National surveillance for this complication terminates in May 2012 and we urge all UK ophthalmologists to report cases to us via BOSU or directly to ten.shn@krapnahtanoj in order to investigate this disastrous complication thoroughly.