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

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Clinical question/level of evidence: Therapeutic, III.