Figure.

Surgical dose-response effect for total binocular lateral rectus (LR) resection (left) or medial rectus (MR) recession (right) in divergence paralysis esotropia. The black symbols and linear regression fits indicate observed data for LR resection (squares) and MR recession (triangles), while corresponding blue symbols and fits indicate recommended values from surgical dose recommendations of Parks et al.¹⁹ Note that except for the published recommendations for MR recession with a slope of 5.00 Δ/mm, the observed slopes for both LR resection and MR recession and recommended LR resection are almost precisely half of this value at about 2.50 Δ/mm. This means that the incremental surgical response of divergence paralysis esotropia to MR recession is half that recommended by Parks et al for esotropia (ET) generally.¹⁹ Δ indicates prism diopter.