Purpose <p>To evaluate the effect of the levator muscle-conjoint Fascial Sheath Complex Suspension on ocular biometric parameters and refractive status in children with congenital blepharoptosis.</p> Methods <p>We reviewed the clinical records of 68 patients with congenital blepharoptosis who attended our hospital from 2021 to 2023 and underwent ptosis surgery with detailed examination. The changes of corneal topography and refractive characteristics before and 1 month, 3 months, 6 months after surgery were compared and analyzed.</p> Results <p>Before surgery, ptosis eyes had statistically significant flatter flat keratometry (<i>P</i> = 0.015), thicker subfoveal choroidal thickness (<i>P</i> = 0.021), higher astigmatic magnitude(<i>P</i> = 0.006) than non-blepharoptosis eyes. The 1-month postoperative steep keratometry and the astigmatic magnitude were significantly higher than the preoperative values in unilateral ptosis (<i>P</i> = 0.032, <i>P</i> = 0.014), without affecting astigmatic power vectors and central corneal thickness (<i>P</i> &gt; 0.05); The astigmatic magnitude at 3 months after surgery were higher than the preoperative values in unilateral ptosis (<i>P</i> = 0.042). In all patients, the postoperative change of astigmatic magnitude was greatest in severe ptosis.</p> Conclusions <p>Ptosis repair surgery for congenital ptosis seems to cause increase of steep K value and astigmatism over early postoperative period but no refraction alteration over the long-term postoperative period. A significant myopic shift was observed at the 6-month postoperative follow-up in severe unilateral ptosis.</p>