Objective To explore the surgical effect of Check ligament suspension in the treatment of severe congenital

ptosis. Methods This was a single institution retrospective study that included patients who underwent check ligament suspension for severe congenital blepharoptosis from June of 2022 to December of 2023. Preoperative data collected included age， sex， margin reflex distance 1 （MRD1）， levator function， and lagophthalmos. Postoperative evaluation including correction result， eyelid closure function was performed at the last follow-up. Results A total of 86 patients （125 eyes） were included in this study. There was a significant improvement between the post- and pre-operative MRD1（P<0.001）， and 115 eyes showed successful correction. Postoperatively， the mean residual lagophthalmos was （0.58±0.57） mm， and 119 eyes showed excellent or good eyelid closure function. Conclusion Check ligament suspension can achieve good correction effect in the treatment of severe congenital ptosis with few complications， such as insufficient correction， residual lagophthalmos， and conjunctival prolapse.

Check ligament, Severe congenital blepharoptosis, Controversy, Complication