To the Editor.
—The article comparing recession-resection and bimedial recession for childhood esotropia by Bartley et al1 is of major value because it demonstrates that a retrospective study based on the clinical experience of one well-recognized strabismus surgeon cannot answer the question of whether bimedial recessions or unilateral recess-resect surgery is better, "in general," for childhood esotropia. Not only was "preoperative esotropia... found to be significantly greater in three of the four categories recorded among the bimedial recession population," but the authors also clearly stated that they grouped those patients whose esotropia began in infancy with those who acquired esotropia later in life. Most strabismus surgeons report that infantile patients with esotropia have larger angles than those who acquire esotropia later in life and that infantile patients with esotropia have a much higher reoperation rate than children with acquired esotropia. Those who acquire esotropia later in life have
Mims JL. Childhood Esotropia. Arch Ophthalmol. 1985;103(7):889. doi:10.1001/archopht.1985.01050070015004