According to our observation and treatment on 21 CES cases, they could be divided into two types, and the distinction was the developing condition of palpebral tissues. Beside the two stage technique to treat 13 CES cases, the one stage technique was also used to treat 8 CES cases by modification of the management of medial canthal ligament, e.g. partially shortening the lateral part of the superficial head of medial canthal ligament. The key is the amount of the horizontal tension of upper eyelid subsequent to medial canthoplasty. The follow-up time was 7 years. Comparing the pre- and post-operative examination results of both one stage and two stage techniques, it was shown that both of them could achieve the goals of enlarging the eyelid fissure and completely elevating the upper eyelid.