Purpose: To determine if Muller's muscle and conjunctiva resection with or without tarsectomy is an efficacious procedure for the treatment of severe involutional blepharoptosis. Methods: A retrospective chart review was performed for all consecutive patients with severe involutional blepharoptosis during a 12-year period treated by a single surgeon (AMP) with a Muller's muscle and conjunctiva resection with or without tarsectomy. The inclusion criteria was good levator function (>=10 mm eyelid excursion), adequate response to phenylephrine (change in eyelid height >=1.5 mm), and severe involutional blepharoptosis (margin-to-reflex-distance-1
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