Baseline characteristics of the study group.

PurposeTo assess how preoperative clinical factors influence surgical outcomes following posterior-approach blepharoptosis repair.DesignProspective cohort study.MethodsWe conducted a prospective analysis of patients undergoing posterior-approach ptosis repair from 2022 to 2024. The primary outcome was change in marginal reflex distance 1 (ΔMRD1) at a 3-month follow-up. Secondary outcomes included inter-eye symmetry, contour, patient satisfaction (graded 0–2), surgery duration, and complication rates. We analyzed outcomes across three clinical subgroups: degree of ptosis (MRD1 ≥ 1 mm vs 8 mm vs 4–8 mm), and phenylephrine test result (positive vs negative).ResultsA total of 231 eyes were included. Mean MRD1 improved significantly from 0.14 ± 1.5 mm preoperatively to 4.0 ± 0.8 mm postoperatively (P ConclusionsPreoperative factors such as ptosis severity, levator function, and phenylephrine test result influence surgical planning but do not affect the final outcomes of posterior-approach blepharoptosis surgery. This evidence supports broader application of minimally invasive posterior approaches in clinical practice.