{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:53:03Z","timestamp":1771980783273,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T00:00:00Z","timestamp":1666310400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004826","name":"Natural Science Foundation of Beijing Municipality","doi-asserted-by":"publisher","award":["7194249"],"award-info":[{"award-number":["7194249"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015286","name":"Hebei Provincial Key Research Projects","doi-asserted-by":"publisher","award":["18277797D"],"award-info":[{"award-number":["18277797D"]}],"id":[{"id":"10.13039\/501100015286","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012492","name":"Beijing Outstanding Talent Training Foundation","doi-asserted-by":"publisher","award":["2018000021469G208"],"award-info":[{"award-number":["2018000021469G208"]}],"id":[{"id":"10.13039\/100012492","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the surgical outcomes of modified combined fascia sheath (CFS) and levator muscle (LM) complex suspension for the correction of severe congenital blepharoptosis in pediatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pediatric patients with severe congenital blepharoptosis were enrolled form July 2017 to July 2021. All patients were divided into two groups according to their age (group A\u2009\u2264\u20097 years; group B\u2009&amp;gt;\u20097 years) and received CFS\u2009+\u2009LM suspension surgery. Main surgical outcome indexes include margin reflex distance 1 (MRD1) and MRD1 regression. Postoperative complications such as lagophthalmos (LAG), conjunctival prolapse, exposure keratopathy and trichiasis were documented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty patients (60 eyes) were enrolled, including 17 patients (18 eyes) in group A and 33 patients (42 eyes) in group B. The MRD1 in group A was 3.06\u2009\u00b1\u20090.64\u2005mm at 6 months after the operation, and the MRD1 in group B was 2.64\u2009\u00b1\u20090.69\u2005mm 6 months postoperatively which is significantly lower than that of group A (<jats:italic>P\u2009<\/jats:italic>=\u20090. 044). At the last visit, however, the MRD1 in group A was 3.00\u2009\u00b1\u20090.69\u2005mm and the MRD1 in group B was 2.64\u2009\u00b1\u20090.70\u2005mm. There was no significant difference in MRD1 between two groups in long term (<jats:italic>P\u2009<\/jats:italic>=\u20090.255). Additionally, there were a variety of degrees of MRD1 regression, especially in the first month after the operation in both groups (both <jats:italic>P\u2009<\/jats:italic>&amp;lt;\u20090.001). Moreover, there were 9 cases of postoperative complications in group A and 13 cases in group B. The overall occurrence of postoperative complications in group A was significantly lower than that in groups B (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup><jats:italic>\u2009<\/jats:italic>=\u20094.413, <jats:italic>P\u2009<\/jats:italic>=\u20090.036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CFS\u2009+\u2009LM suspension, a modified CFS-based surgery, is an effective treatment for severe congenital blepharoptosis in pediatric patients. Moreover, CFS\u2009+\u2009LM suspension demonstrate excellent long-term outcomes, including good movement of the eyelid, satisfied eyelid closure and fewer postoperative complications.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.954365","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T07:53:14Z","timestamp":1666338794000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Modified conjoint fascial sheath suspension for the correction of severe congenital blepharoptosis in pediatric patients at different 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