The suture adjustment technique is one of the most useful techniques I have learned since coming to Children’s. It really reflects the characteristics of Children’s Hospital. Currently, with the constant updating and advancement of strabismus theory, more scholars advocate early surgery for strabismus, which not only improves the appearance, but also creates an opportunity for the child to establish and develop binocular vision. However, children who come to the children’s hospital are so young that surgery must be performed under general anesthesia, and under general anesthesia the surgeon can only complete the surgery based on experience and the theoretical amount of surgery, in order to solve the problem of high re-operation rate of children’s strabismus, we have adopted a modified extraocular muscle quantitative adjustment suture technique invented by clinical practice for many years in the operation of children’s strabismus, so that the one-time success rate of surgery is as high as 93% The success rate of the surgery is more than 93%. We do the specific practice of adjusting children: first open the conjunctiva, make a double set of loop sutures for the posterior migrating straight muscle from 1mm after the muscle stop, cut the muscle before the line, put the two ends of the sutures through the center of the muscle stop in a figure of eight, 2mm apart at the entry point and 1mm at the exit point, pull the two sutures several times to form a scleral attempt, put the sutures through the corresponding conjunctival surface, and then pull the two ends of the line upward tightly and apply bone wax. The sutures are then pulled upward, coated with bone wax, and a strabismus ruler is placed on the line to measure the posterior migration of the muscle, and the black silk thread is knotted at the measurement point, leaving a gap of 3 mm and then knotted again to form an adjustment loop, and the two absorbable sutures are knotted at 5 mm above the adjustment loop and the sutures are cut. Finally, the conjunctival incision is closed with absorbable sutures in counterpoint. The advantages of the above adjustment suture are: 1. The eye position can be adjusted by pulling the adjustment ring during the operation and within 1 to 3 days after the operation, or even before the removal of the suture in 2 weeks; during the adjustment, if overcorrected, the black ring can be pulled backward to reduce the amount of muscle posterior migration; if undercorrected, the black ring can be pulled forward to increase the amount of posterior migration. 2.It is suitable for children with strabismus, especially for internal strabismus with easily changing oblique angle, more complicated vertical strabismus, and various extraocular muscle syndromes. 3.Compared with the traditional adjustment line, it is very convenient to adjust flexibly and freely because we use a suture threaded in the center of the muscle stop end and in a figure-of-eight shape with small needle spacing. 4. It can be used in various anesthesia states, easy to operate, safe and reliable. Adjustment should be noted: 1, the adjustment of undercorrection is more difficult than the adjustment of overcorrection, and should be carried out within 1-3 days after surgery. 2, the adjustment should be gentle, so as not to pull the wire off and cause muscle slippage. 3, The adjustment amount should be carried out in small to large increments. In conclusion, the application of the quantitative adjustment technique of the extraocular muscles has significantly increased the one-time success rate of strabismus surgery. It also enhances our certainty and confidence in the success rate of one-time surgery for younger children. No more delays due to young age, causing regrets to the child and parents. The surgeon can finally get some sleep!