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December 1986

Is the COMS Worthwhile?

Author Affiliations


Arch Ophthalmol. 1986;104(12):1745-1746. doi:10.1001/archopht.1986.01050240019004

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To the Editor.  —In the May 1986 issue of the Archives, Dr Fine1 wrote an editorial supporting the Collaborative Ocular Melanoma Study (COMS). As a physician and a taxpayer, I would like to express my opposition to the COMS. As a physician, I cannot support the study design because of the following reasons:

  1. The credibility of the COMS is somewhat weakened by the fact that several of the outstanding leaders in the field (such as Drs Augsburger, Char, Coleman, Ellsworth, Gragoudas, Seddon, and Shields) are not participating because of problems in the protocol.

  2. The study has a shaky scientific basis. Dr Fine, while professing not to know whether to "take the eye out or leave it in," asserts that he knows what to do with small melanomas. The COMS has excluded melanomas less than 3 mm in height from randomization. What is so magical about 3 mm?

Fine SL:  Do I take the eye out or leave it in? Arch Ophthalmol 1986;104:653-654.Article
 Protocol of the Collaborative Ocular Melanoma Study . National Institutes of Health Guide for Grants and Contracts , vol 15, No. 1, Jan 3, 1986.