Plastic and reconstructive surgery · 2026
Modified Conjoint Fascial Sheath Suspension Technique with Tri-Plane Dissection and Dual-Ligament Fixation for Severe Blepharoptosis: A Clinical Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Xi Wenwen, He ZiQing, Zhang Jianfei, Chen Jie, Shen Yirui, Huang Meifang, Wang Chuqing, Yang Jun, Yang Feng
Аннотация
BACKGROUND: Severe blepharoptosis (MRD1 ≤0 mm with levator function ≤3 mm) poses significant surgical challenges. This study evaluates the efficacy and safety of a modified conjoint fascial sheath (CFS) suspension technique incorporating tri-plane dissection and dual-ligament suspension.
METHODS: A retrospective cohort of 105 patients (123 eyelids) with severe blepharoptosis treated between January 2023 and February 2024 was divided into conventional CFS (n=59 eyelids) and modified CFS groups (n=64 eyelids). The novel technique featured: (1) Tri-plane anatomical dissection (levator aponeurosis plane, Müller's muscle-conjunctival plane, CFS-scleral plane); (2) Dual-ligament suspension (CFS and the check ligament of the superion fornix ); (3) Dual-Ω suture technique for four-layer conjunctival plication. Outcomes included correction efficacy, eyelid retraction, lagophthalmos, complications, and patient satisfaction.
RESULTS: The modified group demonstrated superior outcomes: higher correction rate (93.75% vs 77.97%, p=0.011), reduced complications (6.25% vs 20.34%, p=0.021), and greater patient satisfaction (89.09% vs 74.00%, p=0.045). No conjunctival prolapse occurred in the modified group versus 13.56% in controls.
CONCLUSION: This tri-plane dissection with dual-ligament suspension system achieves precise anatomical reconstruction while minimizing conjunctival complications. The technical refinements address the critical limitation of insufficient height after conventional CFS suspension, offering a reproducible solution for severe ptosis correction.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
METHODS: A retrospective cohort of 105 patients (123 eyelids) with severe blepharoptosis treated between January 2023 and February 2024 was divided into conventional CFS (n=59 eyelids) and modified CFS groups (n=64 eyelids). The novel technique featured: (1) Tri-plane anatomical dissection (levator aponeurosis plane, Müller's muscle-conjunctival plane, CFS-scleral plane); (2) Dual-ligament suspension (CFS and the check ligament of the superion fornix ); (3) Dual-Ω suture technique for four-layer conjunctival plication. Outcomes included correction efficacy, eyelid retraction, lagophthalmos, complications, and patient satisfaction.
RESULTS: The modified group demonstrated superior outcomes: higher correction rate (93.75% vs 77.97%, p=0.011), reduced complications (6.25% vs 20.34%, p=0.021), and greater patient satisfaction (89.09% vs 74.00%, p=0.045). No conjunctival prolapse occurred in the modified group versus 13.56% in controls.
CONCLUSION: This tri-plane dissection with dual-ligament suspension system achieves precise anatomical reconstruction while minimizing conjunctival complications. The technical refinements address the critical limitation of insufficient height after conventional CFS suspension, offering a reproducible solution for severe ptosis correction.CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.