The posterior fixation operation affords the ophthalmologist an additional procedure for the correction of DVD, nystagmus blockage syndrome and abnormal distance/near relationships associated with esodeviations. The authors report that 95% of the patients had improved their control of manifest DVD. The results of surgery for the nystagmus blockage syndrome and abnormal distance/near relationship patients remain inconclusive. The posterior fixation procedure, while technically difficult, may be performed safely by the experienced surgeon. Refinements of the surgical technique are described.