To the Editor.
—The many investigators in the Prism Adaptation Study Research Group are to be congratulated for their hard work and spirit of cooperation in accomplishing the first multicenter prospective study of a strabismus surgical protocol with standardized surgical techniques, methods of measurement, and masked examiners.1Unfortunately, their study was flawed because the original "conventional" surgical protocol called for amounts of surgery (millimeters of bilateral medial rectus recession performed) that were simply too small in the hands of most surgeons. Therefore, anything that increased the amount of surgery (millimeters of bimedial recession) would have increased the success rate over the control group.Their study called for bilateral medial rectus recessions (bimedial) of 3 mm for 15 prism diopters (D) of esotropia (ET), 3.5 mm for 20 D of ET, 4 mm for 25 D of ET, 4.5 mm for 30 D of ET, and 5 mm for 35
Mims JL, Wood RC. Is Prism Adaptation Helpful for Children With Acquired Esotropia? Arch Ophthalmol. 1991;109(4):466. doi:10.1001/archopht.1991.01080040026010
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