Objective To propose and verify the effectiveness of a new surgical method for correcting severe blepharoptosis that integrates both functional and aesthetic rehabilitation. Methods A total of 115 patients （149 eyes） with severe blepharoptosis were treated using the bridge technique （physiological levator aponeurosis complex repositioning）
combined with tarsectomy， and were followed up to evaluate the postoperative outcomes and complications. During the operation， after separating the levator aponeurosis-Müller muscle complex from the tarsus， part of the complex and tarsus were resected， and a three-layer suture technique was used to physiologically reconstruct the levator palpebrae superioris motor system. Postoperative evaluation included the margin reflex distance 1（MRD1）， the position and morphology of the upper eyelid， the symmetry of double eyelids， and the incidence of complications. Results Among the 149 eyes， except for 5 eyes， all achieved good or moderate results， with the eyelids lifted to a normal level and natural appearance. Some cases showed incomplete eyelid closure in the early postoperative period， and no exposure keratitis occurred. Conclusion The bridge technique combined with tarsectomy can be effectively used for the correction of severe blepharoptosis， achieving satisfactory cosmetic and functional reconstruction.
