Magazine article Science News

Study Pans Surgery for Eye Disease

Magazine article Science News

Study Pans Surgery for Eye Disease

Article excerpt

A controversial surgical procedure for a serious eye disorder not only doesn't work, it may make vision worse in some cases, warns a study published this week. Each year in the United States, surgeons perform more than 1,000 of these operations, mainly on older people.

The disorder, known as nonarteritic anterior ischemic optic neuropathy, is characterized by sudden loss of vision due to a painless swelling of the optic disc, a region at the back of the eye where the retina and the optic nerve join. The retina converts visual images to electric impulses that travel along the optic nerve to the brain for processing.

Beginning in 1989, several small studies suggested that this surgical procedure, which eases swelling, could improve vision for people afflicted with the disorder. The operation proved very popular. Nonetheless, many ophthalmologists continued to note that the surgery's worth had yet to be proved by a rigorous test.

In 1992, the federal government decided to change that by launching the "first large, randomized clinical trial looking at the safety and efficacy of the procedure," says Scott M. Whitcup, clinical director of the National Eye Institute in Bethesda, Md. A report in the Feb. 22 Journal of the American Medical Association (JAMA) describes the trial's results.

Investigators at 25 U.S. clinics recruited 244 men and women with nonarteritic anterior ischemic optic neuropathy. They randomly assigned 119 to receive surgery. The remaining 125 got no surgical treatment, but researchers monitored their vision closely.

After 6 months, 43 percent of the no-surgery group could see three or more additional lines of letters on a standard eye chart. In contrast, just 33 percent of the surgery group demonstrated the same boost in performance.

The findings suggest that many such patients improve on their own, without intervention. …

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