Increasing evidence for syndromic phenotypes associated with RPGR mutations.

knowledge of lidocaine and physiology of the human iris, we can only speculate on its mechanism of action and the differences between the subsets observed in our study. Dr. Sodhi has suggested several mechanisms based on a literature review. They are interesting proposals, but to what extent those mechanisms are responsible for the differing effect of lidocaine on pigmented irides, we cannot say. We agree that further investigation is needed to clarify our finding that intracameral lidocaine dilates the human pupil. Despite the differences in our technique for trabeculectomy, the main point of our paper was the finding that pupil dilation is produced by intracameral lidocaine alone, and this needs to be recognized by surgeons who use this anesthesia technique. As Dr. Sodhi suggests, we have also found pupil dilation from intracameral lidocaine to be an aid in combined cataract and glaucoma surgery. JOHN J. LEE, MD MARLENE R. MOSTER, MD JEFFREY D. HENDERER, MD JAIME H. MEMBRENO, MD Philadelphia, Pennsylvania