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April 1988

Treatment of Partly Accommodative Esotropia With a High Accommodative Convergence-Accommodation Ratio-Reply

Author Affiliations

Madison, Wis

Arch Ophthalmol. 1988;106(4):447. doi:10.1001/archopht.1988.01060130489007

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In Reply.  —Any clinical trial of two treatment modalities only compares their relative efficacy when used in exactly the same manner in which they were used in that trial. Thus, it is appropriate for Dr Simonsz to question whether our poor results with the posterior fixation suture with recession operation resulted from our specific recession formula rather than the use of the posterior fixation suture per se. Our data, however, suggest that this is not the case.Our retrospective review of patients with partly accommodative esotropia, with a high accommodative convergence-accommodation ratio, who were operated on between 1974 and 1980, indicated that in this group of patients the response to surgery (prism diopters per millimeter of recession) was inversely related to the accommodative convergence-accommodation ratio. I am unaware of any studies in the literature that contradict this finding. The data from our review suggest that the amount of recession that

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