Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998
Dr Kushner1 reports favorable results in bilateral recession of the lateral rectus for intermittent exotropia by targeting the quantity of deviation uncovered by using targets outside a window (at 0.25 miles) and/or patching over one eye for 1 hour. His high percentage of satisfactory results from initial surgery is to be congratulated, but I am puzzled by an observation concerning his study. In both the control series (treated by conventional quantities of surgery for exotropia measured with targets at 6 m) and the study group (those treated for the larger angle of deviation found on retesting with 0.25-mile targets and/or after 1 hour of patching) he reports only 1 overcorrection at 1 year in both groups. This overcorrection rate is low when compared with the 6% to 20% rate reported in other series, including my own.2,3 The monofixation syndrome has been found in 5% to 10% of previous series and is usually a small motor angle esotropia with peripheral fusion, but poor stereoacuity.3- 5 Dr Kushner's report does not include any mention of this syndrome as a result of surgical treatment for his series so perhaps he did not encounter these overcorrections.
Ing MR. Intermittent Exotropia: Far Distance Target for Surgical Dosage. Arch Ophthalmol. 1998;116(11):1550-1551. doi: