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Almost all articles about the treatment of esotropia consider a successful outcome to range between small-angle esotropia and small-angle exotropia (typically 8-10 PD). Similarly, they do not differentiate between the manifest deviation and the manifest plus latent deviation. Our study convinced me (and I hope the readers) that these differences are important and that these different outcomes should not be lumped together when defining success. Alignment within ±8 PD is an inadequate and imprecise criterion. Small-angle esotropia is better than small-angle exotropia; orthotropia is even better. It therefore amused me that although most articles I have read about esotropia use this inadequate criterion, our study is questioned because our definition of success described an outcome that was not "perfect enough."Although I agree with most (not all) of the points raised by Drs Scott and Arthur, the thrust of their letter addresses what constitutes a cure (or perfect
Kushner BJ. Is Alignment Within 8 Prism Diopters of Orthotropia a Successful Outcome for Infantile Esotropia Surgery?-Reply. Arch Ophthalmol. 1996;114(12):1531. doi:10.1001/archopht.1996.01100140728022
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