We appreciate Dr Hawkins' letter and his concern for our negative results with lamina puncture. His concerns will benefit from reviewing the information clearly shown on page 973 and repeated in Table 1 indicating that these patients represented a mix of nonischemic and ischemic central retinal vein occlusions. Our interest was not to champion a particular understanding of the pathophysiology of central retinal vein occlusion and its potential reversibility, as there are many interpretations that are widely contested. Rather, we described the consecutive results of a sensibly designed intervention in typical patients with central retinal vein occlusion, after having performed careful preliminary studies in experimental animals. We, like Dr Hawkins, are saddened by the fact that our results with lamina puncture were thoroughly negative, and we continue to explore new medical and surgical approaches to this disease.
D’Amico DJ, Lit ES, Viola F. Optic Disc Puncture Evaluation—Reply. Arch Ophthalmol. 2007;125(4):577. doi:10.1001/archopht.125.4.577-b