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Abstract #5849 Published in IGR 2-1
The direction of glaucoma surgery: Why improvements are occurring so slowly
Spaeth GGraefe's Archive for Clinical and Experimental Ophthalmology 2000; 238: 205-206
in this editorial the author suggests some improvements for our evaluation for glaucoma surgery. The author also feels that we ask the wrong questions and that we have been looking for the wrong outcomes. Glaucoma is not IOP but decrease of functional function and even better decrease quality of life. Of 50 articles on this subject reviewed by the author only 2% dealt with quality of life and 14% with visual field. Furhther more all science must control bias as much as possible: 1. The new procedure must be compared to some Gold standard. 2. The data must be obtained in a way that limits bias. This usually requires randomization so that the groups compared are truly comparable. Publications on glaucoma surgery are not doing well in this regard. Only 6% of the studies evaluated by this author were controled studies involving a measure of visual function. This author suggests: 1. Use a standard grading method. 2. Do not accept papers that do not include assessments of quality of. 3. Not to accept papers that do not include methods of limiting bias. 4. Better definitions of the study population. 5. To develop an international committee to plan the direction of glaucoma surgery, providing guidelines for research and development. The author concludes that it is likely that if we start studying the proper outcomes, specifically, not just the intra-ocular pressure, but the course of the glaucoma or preferably the health of the patien, and if we start employing well-established scientifique techniques within a reasonable period of time, the surgical treatment of glaucoma will progress in the right direction.
G. Spaeth, Glaucoma Service, Wills Eye Hospital, 900 Walnut Street, Philadelphia, PA 19107-5598; United States
Classification:
12.1 General management, indication (Part of: 12 Surgical treatment)
15 Miscellaneous
