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 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.