Objective To investigate the effectiveness of posterior scleral reinforcement (PSR)combined with strabismus surgery for treating pathological myopia and strabismus.Methods In this case-series study,33 patients with pathological myopia and strabismus were treated between March 2005 and August 2009 in Eye Hospital of Wenzhou Medical College.Patients ranged in age from 5 to 65 years old.In all cases,the angle of strabismus was greater than 15°; 31 patients were exotropic and 2 were esotropic.Pathological myopia ranged from-8.00 to-30.00 D.All corrected visual acuity was less than 4.9.The patients were divided into 3 groups by age.The modified Snyder-Thompson PSR and strabismus surgery were performed on the 33 patients.Data were analyzed with a paired t test.Results After 1 to 5.3 years of follow-up,only the children's group showed a statistically significant change in the eyes length (t=-2.56,P=0.025).When eyes were rechecked with optical coherence tomography,the macular hemorrhage in 2 eyes had faded,the retina foveoschisis in 3 eyes had disappeared and 2 eyes had became shorter.The residual strabismus of 4 patients was 10°; the residual strabismus in the other patients was less than 5°.All patients were satisfied with the improvement in the eyes' appearance.Conclusion PSR combined with strabismus surgery can prevent or delay the progress of myopia,improve the eyes' appearance,and reduce the pain that would result if each operation were done separately.The combined surgery also reduces adherence restrictions and the difficulty of the operation for doctors.PSR combined with strabismus surgery is feasible and safe.