Can strabismus be fully corrected in one surgery?

Adjustable Suture Technique for Children's Strabismus is an innovative surgical method we began researching in 1985. At that time, only Peking University First Hospital and our institution were developing this technique in China. After nearly 30 years of continuous refinement and practice, we have successfully performed strabismus surgeries on nearly 8,000 children using this method, including numerous complex cases. Today, Dr. Yu Gang and Dr. Wu Qian will explain this specialized procedure to parents.

For children, strabismus is far more than just a cosmetic issue—it directly impacts visual development. Delayed treatment can not only lead to amblyopia but may ultimately result in the loss of binocular vision, causing severe consequences for future work and life. Therefore, childhood strabismus should be treated surgically as early as possible upon detection.

Congenital esotropia should be corrected before age 2, while general strabismus cases are best treated around 5-6 years old. However, since young patients require general anesthesia, surgeons can only rely on experience and theoretical calculations during the procedure, without the ability to observe and adjust eye alignment intraoperatively. International studies report reoperation rates as high as 30-35% for pediatric strabismus, meaning many children require second or even third surgeries, creating significant psychological burden for parents.

To address this high reoperation rate, we developed a modified quantitative adjustable suture technique for extraocular muscles through years of clinical practice. This approach has achieved a first-surgery success rate exceeding 90%.

Among our young patients, 30-40% require postoperative suture adjustment to modify the angle of correction. This technique is particularly suitable for:

Young children who cannot cooperate fully with examinations but need early surgery to enable binocular vision development;

Cases with highly variable preoperative deviation measurements where a consistent angle cannot be determined;

Complex cases requiring simultaneous vertical and horizontal muscle surgeries on both eyes, or when vertical muscle procedures need to be staged;

Special types of strabismus.