Efficacy and Safety of Conjoint Fascial Sheath (CFS) Suspension in the Treatment of Blepharoptosis: A Systematic Review and Meta-analysis

Abstract Background This study focuses on blepharoptosis, a common condition in oculoplastic surgery characterized by drooping of the upper eyelid. The efficacy and safety of using the combined fascial sheath (CFS) to correct blepharoptosis are still unclear. Methods A systematic search encompassing four databases (PubMed, Embase, Web of Science, and Cochrane Library) up to December 15, 2023, was conducted. The meta-analysis was performed using Stata 14. Results A total of 10 studies involving 683 patients were included. The meta-analysis indicated a significant improvement in mean marginal reflex distance 1 (MRD1) in the CFS group compared to the control group (WMD: 2.33; 95% CI 1.61 to 3.06; I 2 =97.2%, P < 0.001). Additionally, patient satisfaction in the CFS group was significantly higher than in the control group (OR: 5.28; 95% CI 1.71 to 16.32; I 2 =0, P = 0.683), and the complication rate was significantly lower (OR 0.26; 95% CI 0.14 to 0.48; I 2 =0, P = 0.899). However, no significant difference in curative effect was observed between the two groups (RD: 0.15; 95% CI −0.01 to 0.31; I 2 =88.3%, P < 0.001). Conclusion CFS suspension has the potential to significantly improve MRD1 and patient satisfaction, while exhibiting a low incidence of complications and a favorable safety profile. These findings indicate that clinicians might consider CFS suspension as a viable treatment option for blepharoptosis. However, it is important to exercise caution due to inter-study heterogeneity and the limitations of current analysis. Level of Evidence III 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