To the Editor.
—In the June 1987 issue of the Archives, the results were published of a study by Kushner et al1 on the treatment of accommodative convergence excess, with bilateral medial rectus recessions or recessions with 14-mm posterior fixation sutures. Posterior fixation surgery was considered an unsatisfactory technique in this study, a conclusion based mainly on the frequent occurrence of overcorrections, although large undercorrections also occurred in the recession with posterior fixation suture group. Mims,2 in a letter to the editor in the September 1987 issue of the Archives, reached a similar conclusion: six overcorrections in a group of 30 patients.We think that at least some of these overcorrections were caused by adding a large, uniform-dose posterior fixation operation to a recession that, by itself, was appropriate for the angle measured at distance fixation. It must be realized that posterior fixation surgery not only reduces the
Simonsz HJ. Treatment of Partly Accommodative Esotropia With a High Accommodative Convergence-Accommodation Ratio. Arch Ophthalmol. 1988;106(4):447. doi:10.1001/archopht.1988.01060130489006