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 that pha_.acological treatment if the eye
 continued to lose vision and [lOP] was
 uncontroil_le . o . Then one would resort
 Filtration surgery is one common form of surgical
 intervention_ Dr. _epler described this procedure as follows:
 The usual surgical procedures enlarge the
 _i. mechanism which drains the fluid from the
 eyes The rlsY_ Qf such procedures include a
 significant chance that the opening will not
 be made large enough ands therefore_ it will
 not be effective in reducing iOP to the safe
 ranges or that it will be too laz_/e ands
 therefore_ will reduce XOP beneath the safe
 range. The possibility of unsuccessful
 surgery is increased in patients with
 sharply fluctuating 16P_ because of the
 inability to determine the extentA_whioh
 the mechanism should be enlarged® _I
 The failure rate of surgical interventions -- deEined
 as a failure of the procedure to reduce lOP and discounting
 potential adverse consequences -= remains extremely high. Keith
 Green_ Ph. Do testified X[There is] probably a 50%_ 60% failure
 rate in glaucoma surgery_ simply because the ihuman body tries to
 heal itself. _460/
 Xn recent years_ an additional surgical option has
 emerged_ laser su_ery_ Opinions vary sharply with respect to
 the effectiveness of this procedure. Keith Greens Ph_Do,
 testifying on behalf of the government commented, "_n the hands
 of the skilled utilizer of the lasers I think, the latest numbers
 _/ Cross-examination of Keith Greene Ph.D._ Tr. 9_169o
 _59/ Affidavit of Robert Randall_ Exhibit 2 B_ Affidavit of Dro
 Robert Hepler _ 11; Cross-examination of Keith Green, Ph.D., Tr.
 _6Q/ Cross-examination of Keith Greene Ph®Do_ Tr. 9-i01o
 - 139

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