To investigate clinical outcomes and to analyze the factors of successful treatment of conjunctiva-Müller muscle resection (CMMR) in patients with mild to moderate ptosis.

The medical records of 22 patients (30 eyes) with upper lid ptosis were retrospectively reviewed. All patients underwent conjunctiva-Müller muscle resections, and four patients (seven eyes) underwent concurrent upper lid blepharoplasty. The mean follow-up period was 81.62 ± 21 days. Pre- and post-operative MRD1, IPF and pupil to brow distance were measured using the Image J program. A preoperative phenylephrine test and a pathologic examination were performed to analyze the presence of Müller's muscle and the tear secreting glands from the CMMR specimens.

The overall success rate of the procedure was 93%. Postoperatively, the MRD₁ increased on average by 1.47 mm ( p = 0.00) and increased by an average of 1.72 mm when the phenylephrine test response was greater than 2 mm and by 0.99 mm when the response less than 2 mm. The Müller muscle was observed in every specimen.

Conjunctiva-Müller muscle resection is an effective and safe method for treating mild to moderate ptosis, for which the preoperative phenylephrine test result is the most important factor for surgical success.