To invastigate the clinical efficacy of check ligament suspension for severe congenital blepharoptosis.

Sixty-four eyes of 48 patients of severe congenital blepharoptosis were divided randomly into trial group, suspension of the eyelid to the check ligament(34 eyes of 24 cases); and control group, frontal muscle suspension surgery (30 eyes of 24 cases). The clinical efficacy was compared according to the condition of the palpebral height, eyelid margin radian, edema, palpebral fissure closure and lid lag after surgery.

After following up for 6-24 months, eyelids were all raised and appearance was improved in both groups. In trial group, the edema was less, the eyelid was more natural and lid lag was less. In control group, 4 of the 24 patients were undercorrection, 1 patient's eyelid margin radian was not good and 1 patient got trichiasis. Patients in control group had more severe edema and obvious lid lag. Two patients' palpebral fissure closure was delayed. Lagophthalmos in 6 eyes still existed 6 months after surgery.

The suspension of the check ligament instead of musculi levator palpebrae superioris has reliable efficacy. The movement of upper eyelid is identical to the physical status, and the appearance of eyelids is more natural after surgery.

Blepharoptosis, congenital, severe; Check ligament suspension