”With the introduction of the operating microscope into ophthalmic surgery, the era of microsurgery in ophthalmology was opened, ushering in a new era of modern cataract surgery and vitreous surgery. When the era of ophthalmic microsurgery has passed half a century, the international community still advocates wearing a 2-3 times magnifying glass for strabismus surgery. Is microsurgery only for inner eye surgery?” The current National Ophthalmology Chairman, Prof. Zhao Kanxing, Chairman of Strabismus and Pediatric Ophthalmology, called on our strabismus and pediatric ophthalmologists, especially the young ones, to encourage them to actively carry out microscopic strabismus correction in the 11th issue of the Chinese Journal of Ophthalmology in 2011. At the same time, the Strabismus and Pediatric Ophthalmology Group of the Chinese Medical Association has been actively leading efforts to explore the positive significance of microsurgery in strabismus correction and to explore ways to improve the quality of surgery. The 14th National Symposium on Strabismus and Pediatric Ophthalmology held in Jinan in June 2011 had another lively exchange and discussion on this issue. At present, most of the strabismus correction in China is still operated under direct vision of naked eyes, some doctors apply magnifying glass, and a few doctors apply microscope. The strabismus correction in our hospital has been in the forefront of the country, and the strabismus surgery reaches thousands of cases every year. In the era of increasing pursuit of small incisions and small trauma, strabismus correction should be obliged to join the ranks of minimally invasive surgery. Early postoperative changes in refractive error, corneal astigmatism, and effects on the tear film caused by conventional corneal rim incisions have been reported. Therefore the fornix-conjunctival incision has been promoted by many oculomotor surgeons in recent years. However, due to the characteristics of extraocular muscle surgery, the tiny incision under surface anesthesia can cause excessive stretching of the extraocular muscle, causing discomfort to the patient and aggravating the oculocardiac and oculogastric reflexes. For some sensitive patients, at the patient’s request strabismus and pediatric ophthalmology in collaboration with anesthesiology apply remifentanil anesthesia, so that the patient can undergo minimally invasive surgery under the microscope under awake and painless. The operator can observe the eye position at the same time, which ensures the surgical result and saves the patient from pain. Compared with the traditional trapezoidal conjunctival incision for comparison, the incision is small, bleeding is less, and intraoperative hemostasis is basically unnecessary. The surgical trauma is reduced, the blood vessels are clearly separated under the microscope, and the musculoscleral suture is more secure and reliable. At present, this technology has basically matured, with hundreds of surgeries and a strabismus correction orthoptic rate of more than 95%. Surgical method: The German ZEISS surgical microscope is applied, and conventional microsurgical instruments are used. The muscle forceps and locking needle holder produced by Suzhou Yifeng Bell are the necessary instruments. Under the microscope, the bulbar conjunctiva is opened in the fornix parallel to the direction of the lid fissure, and the subconjunctival tissue is opened perpendicular to the conjunctival incision, with an incision length of 5 mm. after exposing the sclera, the extraocular muscle is hooked, and after checking that the hooking is complete, another strabismus hook is used to glide under the conjunctiva with the muscle surface to separate the connection during the period, and then the muscle is pulled out. 6-0 absorbable suture is used to close the muscle. After that, the surgery is performed in the same way as the conventional strabismus correction surgery. After surgery, the bulbar conjunctiva is repositioned and may be left unstitched or the bulbar conjunctiva may be closed with one stitch of 8-0 absorbable suture. In older individuals, sutures may be required due to the thinness of the bulbar conjunctiva. Conjunctival edema is light, recovery is quick, and you can work and study after discharge.