Strabismus is not only a cosmetic problem for children, but also directly affects their visual development. Delayed treatment can lead not only to amblyopia, but also to the eventual loss of monovision in both eyes, which can have serious consequences for their future working life. Therefore, children with strabismus should be treated surgically as soon as it is detected. Congenital internal strabismus should be operated before two years old, and general strabismus should also be operated around 5-6 years old. However, due to the young age of children, surgery must be performed under general anesthesia, and under general anesthesia the surgeon can only complete the surgery based on experience and theoretical surgical volume, and cannot observe and adjust the eye position during the surgery. In order to solve the problem of high reoperation rate of children’s strabismus, our hospital has adopted a modified posterior migration adjustment suture technique for children’s strabismus after years of clinical practice, resulting in a one-time success rate of over 90%. More than 40-50% of children who undergo strabismus surgery need to adjust the strabismus degree that has changed through the adjustment suture, and the adjustment suture is suitable for the following: 1. Children who need to perform multiple vertical and horizontal muscle surgeries on both eyes at the same time, or vertical muscle surgeries often need to be performed in two separate surgeries; 4. In conclusion, the application of the posterior migrating suture of the extraocular muscle has significantly increased the one-time success rate of strabismus surgery. The pediatric ophthalmology has made the reoperation rate significantly lower by this adjustment suture surgery, especially in children with strabismus, which has given us great certainty and confidence in the one-time success rate of surgery at a younger age.