Purpose To characterise the results of the largest patient series to date undergoing closed conjunctival delayed adjustable suture techniques.

Methods A multicentre retrospective review of 440 operations (patients aged 10–91 years) by five surgeons at four centres were evaluated for surgical outcomes associated with the delayed adjustable suture technique.

Results 26% (116 of 440) of all patients required postoperative manipulation, with individual surgeon rates ranging from 13% to 56%. The majority of these patients did not complain of diplopia in target gaze and/or had satisfactory cosmetic improvement as evaluated at the 1–3 months follow-up visit (84%). Transient complications included dellen, poor conjunctival appearance, filamentary keratitis, infection, granuloma, exposed suture and corneal abrasion. Serious complications were rare.

Conclusions This large multicentred series characterises the closed conjunctival delayed adjustable suture technique for the correction of strabismus. It may present some significant advantages to more traditional adjustable suture techniques.