We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Viewpoint |

Ethics of Placebo Procedures in Ophthalmic Surgical Trials

Maxwell W. Dixon, BS1; Cagri G. Besirli, MD, PhD2
[+] Author Affiliations
1Currently a medical student at University of Michigan Medical School, Ann Arbor
2W. K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor
JAMA Ophthalmol. 2016;134(1):11-12. doi:10.1001/jamaophthalmol.2015.4650.
Text Size: A A A
Published online


This Viewpoint assesses the ethical justification for the use of placebo procedures in ophthalmic surgery trials.

Novel therapeutics, including ocular gene and stem cell therapies, hold great promise to maintain and improve vision in many ocular disorders. Although the theoretical rationale and preclinical data may be encouraging, differentiation of the placebo effect from apparent benefits of these new therapies via well-designed surgical clinical trials is critical. Sham or placebo surgery has proven to be indispensable in identifying nonefficacious therapies in numerous surgical trials.1 Perhaps the most notable example is knee arthroscopy. This procedure was chosen frequently by orthopedic surgeons for osteoarthritis until multiple placebo-controlled studies found no significant difference in pain reduction or functional outcomes.2 Critics of sham surgery argue that the risks to research participants outweigh the benefits in evaluating new treatment modalities. Because constraints on the use of invasive sham surgery in ophthalmology are less well established than in other areas of medicine, how do we determine when the placebo arm is ethically justified or even permissible?


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.