Severe Blepharoptosis Correction with the Fixation of Levator Complex and Conjoint Fascial Sheath

The correction of severe blepharoptosis is one of the most challenging operations in plastic surgery. This study introduces a novel self-reinforced fixation technique combining the levator complex with conjoint fascial sheath for the correction of severe blepharoptosis and reviews the postoperative results over the preceding 12 years.

This retrospective review included all patients who underwent self-reinforced fixation with or without conjoint fascial sheath at the authors' center between 2010 and 2022. The clinical data of the 2 groups were collected and evaluated.

All patients were followed up for 6 months to 8 years postoperatively. The mean postoperative marginal reflex distance 1 and levator function increased significantly in both groups. Sufficient correction of ptosis was achieved in 32 (65.31%) and 84 (81.56%) eyelids in groups I and II, respectively. The mean eyelid lagophthalmos was 1.27 ± 0.91 mm and 0.85 ± 0.89 mm in groups I and II, respectively. The most common complication was undercorrection of ptosis, which was observed in 14 eyelids (28.57%) and 15 eyelids (14.56%) in groups I and II, respectively.

The self-reinforced fixation technique was effective in correcting severe congenital ptosis in Chinese patients. The clinical effect was consistent in the long-term follow-up cases, and the recurrence rate was low. Thus, this technique can enhance the strength of the levator muscle and maintain appropriate elasticity of eye closure.

Therapeutic, III.