Partially accommodative esotropia: should you overcorrect and cut the plus?

Abstract

Dr Kushner's article,1published in December issue of theArchives, made several references to an article on which I was first author, entitled Augmented Surgery for Esotropia Associated With High Hypermetropia.2Unfortunately, there seem to be some misunderstandings that require clarification. Dr Kushner describes our article as advocating intentional surgical overcorrection in patients with partially accommodative esotropia, so that the need for hypermetropic correction after surgery may be reduced or eliminated. I regret that our article may have given Dr Kushner this impression. I have never advocated operating to reduce or remove hypermetropic spectacle correction, nor do I know of any article published in United States that advocates this practice. The goal is to achieve orthophoria and binocular fusion with patient wearing full hypermetropic correction. Of 40 patients in our study undergoing augmented surgery, 35 (88%) required full hypermetropic correction. Two