Observational studyAesthetic plastic surgery2026
Anatomy of the Conjoint Fascial Sheath and Modified ''-Shaped Suspension for Correction of Moderate-to-Severe Congenital Blepharoptosis.
Observational study in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe conjoint fascial sheath (CFS) is a fibrous structure essential for the dynamic movement of the upper eyelid. This study investigates the anatomy of the CFS and assesses the efficacy and safety of modified ''-shaped fixation CFS suspension in treating congenital moderate-to-severe blepharoptosis.
methodsThis study included a cadaveric anatomical analysis and a single-center retrospective observational study. The anatomical study was conducted on 10 eyes from five adult cadavers, and the study analyzed outcomes from 51 patients (65 eyes) who underwent surgery from March 2019 to January 2024.
resultsThe CFS appeared as a dense, white sheath between the levator muscle and superior rectus muscle, measuring approximately 11.3 ± 2.3 mm (8-14.8 mm) in length and 1.0 ± 0.28 mm (0.5-1.5 mm) in thickness, located about 3.7 ± 0.9 mm (2.2-5.4 mm) from the upper conjunctival fornix, with a trapezoidal shape. Satisfactory correction was achieved in 62 eyelids (95.4%), with good or fair symmetry observed in 48 patients (94.1%). The most common complications were undercorrection and recurrence, each occurring in three eyelids (4.6%), with no instances of conjunctival prolapse. Transient incomplete eyelid closure was noted early postoperatively but resolved within 1-6 months.
conclusionThe CFS, located between the levator muscle and superior rectus muscle, provides effective correction of congenital moderate-to-severe ptosis. The modified ''-shaped fixation CFS suspension technique shows promising functional and esthetic outcomes, minimizing postoperative conjunctival prolapse and establishing itself as an effective approach for ptosis correction. LEVEL OF EVIDENCE IV: 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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