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April 1991

Is Prism Adaptation Helpful for Children With Acquired Esotropia?-Reply

Author Affiliations

Minneapolis, Minn
Iowa City, Iowa

Arch Ophthalmol. 1991;109(4):466-467. doi:10.1001/archopht.1991.01080040026011

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In Reply.  —Dr Mims and Mr Wood present their view that the Prism Adaptation Trial (PAT) "was flawed because the... [PAT surgical table] called for amounts of surgery... that were simply too small" for the control group, and suggested that surgical amounts should be determined by the use of a dose-response curve described in their 1986 article. In response, we note the following:

  1. There were more overcorrections in the PAT control groups, which received smaller amounts of surgery on average, than in the prism-adapted surgical group. We concluded that prism adaptation appears to identify a subgroup of patients in whom it is safe to perform larger amounts of surgery without increasing the rate of overcorrection. If larger amounts of surgery had been performed routinely in the control groups, it is likely that the number of overcorrections would have increased.

  2. It is not clear, as claimed by Mims and Wood in

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