The goal of a posterior fixation suture (PFS) is a decrease of maximum ocular rotation. “Faden” means “suture” in German and therefore the term “fadenoperation”. PFS are best utilized to reduce incomitant deviations. PFS are used successfully on the medial rectus muscles for persistent accommodative esotropia (to further decrease adduction) and in nystagmus blockage syndrome. PFS is often used in conjunction with a recession in cases of a primary position strabismus and incomitancy in the field of action of the recessed. Two type of techniques are used one is with no muscle recession and in other there is rectus muscle recession. Apply a topical antibiotic/steroid preparation immediately and three times a day for one week in the postoperative care.