Changes in Sunken Eyes Combined with Blepharoptosis after Levator Resection

Background: This study aims to report the changes in sunken eyes combined with blepharoptosis after levator resection. Methods: Analysis involved 60 eyes from 32 patients with sunken eyes combined with blepharoptosis. Advancement of the levator aponeurosis and the Müller's muscle complex (levator resection) was performed in these patients. Area of upper eyelid sulcus (AES) was defined as the area of the upper eyelid shadow. The digital images were converted to black and white using image-processing software (Adobe Photoshop), and the AES was calculated using ImageJ software. In addition, margin reflex distance, eyebrow height (EBH), and AES were measured before and 3 months after surgery to assess the changes in the eyelids. Results: Preoperative AES was significantly correlated to age (P