Efficacy and Safety of Conjoint Fascial Sheath (CFS) Suspension in the Treatment of Blepharoptosis: A Systematic Review and Meta-analysis

IF 2.8 3区医学 Q2 SURGERY Aesthetic Plastic Surgery Pub Date : 2025-02-21 DOI:10.1007/s00266-025-04724-z

Dongshuo Ji, Ying Liu, Xing Han, Shouduo Hu, Yanyong Zhao

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Abstract

Background

This study focuses on blepharoptosis, a common condition in oculoplastic surgery characterized by drooping of the upper eyelid. The efficacy and safety of using the combined fascial sheath (CFS) to correct blepharoptosis are still unclear.

Methods

A systematic search encompassing four databases (PubMed, Embase, Web of Science, and Cochrane Library) up to December 15, 2023, was conducted. The meta-analysis was performed using Stata 14.

Results

A total of 10 studies involving 683 patients were included. The meta-analysis indicated a significant improvement in mean marginal reflex distance 1 (MRD1) in the CFS group compared to the control group (WMD: 2.33; 95% CI 1.61 to 3.06; I²=97.2%, P < 0.001). Additionally, patient satisfaction in the CFS group was significantly higher than in the control group (OR: 5.28; 95% CI 1.71 to 16.32; I²=0, P = 0.683), and the complication rate was significantly lower (OR 0.26; 95% CI 0.14 to 0.48; I²=0, P = 0.899). However, no significant difference in curative effect was observed between the two groups (RD: 0.15; 95% CI −0.01 to 0.31; I²=88.3%, P < 0.001).

Conclusion

CFS suspension has the potential to significantly improve MRD1 and patient satisfaction, while exhibiting a low incidence of complications and a favorable safety profile. These findings indicate that clinicians might consider CFS suspension as a viable treatment option for blepharoptosis. However, it is important to exercise caution due to inter-study heterogeneity and the limitations of current analysis.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266

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联合筋膜鞘（CFS）悬吊治疗上睑下垂的疗效和安全性：一项系统综述和荟萃分析。

背景：本研究的重点是眼睑下垂，这是一种在眼部整形手术中常见的情况，其特征是上眼睑下垂。使用联合筋膜鞘（CFS）矫正上睑下垂的有效性和安全性尚不清楚。方法：系统检索截至2023年12月15日的四个数据库（PubMed、Embase、Web of Science和Cochrane Library）。meta分析采用Stata 14进行。结果：共纳入10项研究，涉及683例患者。荟萃分析显示，与对照组相比，CFS组的平均边际反射距离1 （MRD1）有显著改善(WMD: 2.33；95% CI 1.61 ~ 3.06；I2=97.2%, p < 0.001)。此外，CFS组患者满意度显著高于对照组(OR: 5.28；95% CI 1.71 ~ 16.32；I2=0, P = 0.683)，并发症发生率显著降低(OR 0.26；95% CI 0.14 ~ 0.48；I2=0, p = 0.899)。两组疗效比较差异无统计学意义(RD: 0.15；95% CI -0.01 ~ 0.31；I2=88.3%, p < 0.001)。结论：CFS悬浮液有可能显著改善MRD1和患者满意度，同时具有低并发症发生率和良好的安全性。这些发现表明，临床医生可能会考虑将CFS悬吊作为上睑下垂的可行治疗选择。然而，由于研究间的异质性和当前分析的局限性，谨慎行事是很重要的。证据等级iii：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明www.springer.com/00266。

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来源期刊

Aesthetic Plastic Surgery 医学-外科

CiteScore

4.40

自引率

25.00%

发文量

479

审稿时长

3 months

期刊介绍： Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP). Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships. Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.