Performing scleral sutures in strabismus and retina surgery poses a challenge for residents as it requires high precision and allows only little room for error, with possible complications including endophthalmitis and retinal detachment from scleral perforation or muscle dehiscence.

The human sclera consists of collagen and elastin, with a thickness ranging between 0.33 mm beneath the recti muscles, 0.66 mm at the muscle insertion and 1 mm posteriorly. The three layers …