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New research · Ophthalmology
Aesthetic plastic surgery · 2d
Cohort studyAesthetic plastic surgery · 2026

Anatomy of the Conjoint Fascial Sheath and Modified ''-Shaped Suspension for Correction of Moderate-to-Severe Congenital Blepharoptosis.

Xuejun Ni, Lu Chen, Xiaofen Wan … Xiuying Shan
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OphthalmologyCohort study

Modified conjoint fascial sheath suspension corrected most severe congenital ptosis cases

Anatomy of the Conjoint Fascial Sheath and Modified ''-Shaped Suspension for Correction of Moderate-to-Severe Congenital Blepharoptosis.

Xuejun Ni … Xiuying Shan
Aesthetic plastic surgery · 2026
Background

The conjoint fascial sheath (conjoint fascial sheath) is a fibrous structure essential for the dynamic movement of the upper eyelid.

Purpose

This study investigates the anatomy of the conjoint fascial sheath and assesses the efficacy and safety of modified ''-shaped fixation conjoint fascial sheath suspension in treating congenital moderate-to-severe blepharoptosis.

Methods

This study included a cadaveric anatomical analysis and a single-center retrospective observational study.

n = 65 eyes
Results

in nearly all eyelids, drooping was corrected to a satisfactory position

95.4%
Satisfactory correctio
94.1%
Good/fair symmetry
More results

The conjoint fascial sheath 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.

More results

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.

“
Conclusion · 1 of 3

The conjoint fascial sheath, located between the levator muscle and superior rectus muscle, provides effective correction of congenital moderate-to-severe ptosis.

Conclusion · 2 of 3

The modified ''-shaped fixation conjoint fascial sheath suspension technique shows promising functional and esthetic outcomes, minimizing postoperative conjunctival prolapse and establishing itself as an effective approach for ptosis correction.

Conclusion · 3 of 3

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article.

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