Dermatochalasis of Upper Eyelid
Conditions
Keywords
Upper eyelid blepharoplasty, Compression dressing, Postoperative edema, Postoperative ecchymosis, Split-eye design, Eyelid surgery
Brief summary
This study evaluated whether applying a compression dressing to one eyelid after upper eyelid blepharoplasty (eyelid lift surgery) reduces swelling, bruising, and discomfort compared to the untreated eyelid. In this randomized trial, each participant underwent bilateral upper eyelid blepharoplasty; after surgery, one eyelid was randomly assigned to receive a compression dressing for 24 hours, while the other eyelid received no dressing and served as the internal control. Outcomes including eyelid swelling, bruising, pain, aesthetic appearance, and corneal health were assessed by masked observers on postoperative days 1, 7, 30, and 90. The goal of this study was to determine whether routine use of compression dressing provides a measurable clinical benefit after this common cosmetic and functional eyelid surgery.
Detailed description
This was a prospective, randomized, controlled, observer-masked, within-subject (split-eye) trial conducted at a single academic center between June and November 2025. Adult patients with bilateral dermatochalasis scheduled for upper eyelid blepharoplasty were enrolled. Following bilateral surgery performed by a single surgeon, one eyelid of each patient was randomly assigned by coin toss to receive a compression dressing (folded sterile gauze secured with elastic tape, left in place for 24 hours), while the contralateral eyelid received no dressing and served as the internal control. All patients received standardized postoperative care, including bilateral cold compresses and topical medications. Two masked investigators independently assessed postoperative edema (5-point ordinal scale), ecchymosis (ImageJ-based area quantification), and aesthetic outcome (Global Aesthetic Improvement Scale) from standardized clinical photographs obtained on postoperative days 1, 7, 30, and 90; disagreements were resolved by a third masked investigator. Postoperative pain (visual analog scale) and patient comfort preference were recorded on day 1. Best corrected visual acuity and corneal fluorescein staining (Oxford grading scale) were assessed at each follow-up visit to evaluate ocular surface safety. Between-group comparisons were performed using the Wilcoxon signed-rank test, with Holm-Bonferroni correction applied across outcomes at each visit to account for multiple comparisons.
Interventions
PROCEDURECompression Dressing (CD)
A compression dressing consisting of folded sterile gauze pads followed by a dry gauze layer, secured with elastic tape (Clivex®, Climed Healthcare, Türkiye), applied to one upper eyelid immediately after bilateral upper eyelid blepharoplasty and left in place for 24 hours. The contralateral eyelid remained uncovered and undressed, serving as the internal control.
PROCEDURENo Dressing (Standard Postoperative Care)
The contralateral upper eyelid received standard postoperative care without a compression dressing, remaining uncovered. All other postoperative treatments (topical antibiotic ointment, cooling protocol, medications) were identical to the compression dressing side.
Sponsors
Fatma Poslu Karademir
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Postoperative edema, ecchymosis, and Global Aesthetic Improvement Scale scores were independently assessed by two masked investigators from standardized clinical photographs; disagreements were resolved by a third masked investigator. The masked assessors did not participate in surgery or dressing application and were unaware of side allocation.
Intervention model description
This study used a within-participant, split-eye design rather than a traditional temporal crossover. Each patient's two upper eyelids were simultaneously and randomly allocated (by coin toss) to receive either compression dressing or no dressing during the same surgical session, with the contralateral eyelid serving as the internal control, rather than each participant receiving both interventions sequentially over time.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients (≥18 years) with bilateral upper eyelid dermatochalasis scheduled for upper eyelid blepharoplasty * Willingness and ability to provide written informed consent * Ability to comply with the postoperative follow-up schedule (postoperative days 1, 7, 30, and 90)
Exclusion criteria
* History of prior upper eyelid surgery * Unilateral dermatochalasis * Previous eyelid trauma * Congenital eyelid anomalies * Blepharochalasis syndrome * Coagulopathy * Combined indication for ptosis repair and blepharoplasty * Severe bilateral visual impairment precluding safe application of compression dressing
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative eyelid edema | Postoperative day 1, postoperative day 7, postoperative day 30, postoperative day 90 | Standardized clinical photographs assessed by masked observers using a 5-point ordinal edema grading scale. |
| Postoperative ecchymosis | Postoperative day 1, postoperative day 7, postoperative day 30, postoperative day 90 | Standardized clinical photographs analysed using ImageJ software and graded by masked observers. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain | Postoperative day 1 | Visual analogue scale (0-10) |
| Patient comfort | Postoperative day 1 | Patient questionnaire comparing comfort between the compression dressing and control eyelids. |
| Corneal staining | Postoperative days 1, 7, 30 and 90 | Fluorescein staining graded according to the Oxford grading scale. |
| Global aesthetic improvement | Postoperative days 1, 7, 30 and 90 | Global Aesthetic Improvement Scale assessed by masked observers using standardized clinical photographs. |
| Best corrected visual acuity | Baseline, postoperative days 1, 7, 30 and 90 | Best corrected visual acuity measured in logarithm of the minimum angle of resolution units. |
Countries
Turkey (Türkiye)
Outcome results
None listed