This study aims to evaluate the short and long-term effects of skin-only and skin+muscle excision blepharoplasty on corneal nerves, dry eye parameters, meibomian glands, and eyebrow position.

The study was designed with the approval of the Ethics Committee on Human Research of Marmara University and was conducted following the tenets of the Declaration of Helsinki. Written informed consent was obtained from all patients who received information about the procedure and the postoperative course. The study included 48 eyes of 24 patients older than 18 who applied to Marmara University Oculoplastic and Orbital Surgery Unit due to dermatochalasis and were suggested upper eyelid blepharoplasty for medical or cosmetic purposes. The patients were divided into two groups, Group S (n=12) for skin excision only and Group M (n=12) for skin+muscle excision by the decision of the surgeon. In addition to all ophthalmological examinations, sub-basal nerve plexus parameters with corneal confocal microscopy, Schirmer I test, non-invasive tear break-up time, meibomian gland area loss measurements with infrared meibography, central eyebrow height, and lateral eyebrow height were evaluated at baseline and postoperative 1st week, 1st month and 1st-year follow-ups.

Inclusion Criteria:

• Patients older than 18.
• Patients with dermatochalasis.
• Patients who were suggested upper eyelid blepharoplasty for medical or cosmetic purposes.

Exclusion Criteria:

• Patients who have had previous periorbital or ophthalmic surgery
• Patients with extensive blepharitis
• History of contact lens use
• History of ophthalmic, endocrinological, neurological, or rheumatological diseases
• History of facial paralysis
• Negative Bell's phenomenon
• Schirmer test <5mm
• The patients who had been treated with periocular botulinum toxin in the last 1 year were not included the study.

The data supporting the study findings are available from the corresponding author upon request.

All evaluations and data collection were performed by a blinded investigator.