Does Unilateral Compression Dressing Reduce Postoperative Swelling and Bruising After Upper Eyelid Blepharoplasty? (COMPRESS-BLEPH)

The Effect of Compression Dressing on Postoperative Outcomes After Upper Eyelid Blepharoplasty: A Randomized, Controlled, Observer-Blinded Evaluation Study

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.

Study Overview

• Status: Completed
• Conditions: Dermatochalasis of Upper Eyelid
• Intervention / Treatment: Procedure: Compression Dressing (CD); Procedure: No Dressing (Standard Postoperative Care)

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.

• Study Type: Interventional
• Enrollment (Actual): 56
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul
    • Istanbul, Istanbul, Turkey (Türkiye), 34421
      • Beyoglu Eye Training and Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Compression Dressing (CD); Upper eyelid randomly assigned to receive a compression dressing (folded sterile gauze secured with elastic tape) for 24 hours after surgery.	Procedure: Compression 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.
Active Comparator: No Dressing (ND); Contralateral upper eyelid receiving standard postoperative care without compression dressing, serving as the internal control.	Procedure: No 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative eyelid edema	Standardized clinical photographs assessed by masked observers using a 5-point ordinal edema grading scale.	Postoperative day 1, postoperative day 7, postoperative day 30, postoperative day 90
Postoperative ecchymosis	Standardized clinical photographs analysed using ImageJ software and graded by masked observers.	Postoperative day 1, postoperative day 7, postoperative day 30, postoperative day 90

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative pain	Visual analogue scale (0-10)	Postoperative day 1
Patient comfort	Patient questionnaire comparing comfort between the compression dressing and control eyelids.	Postoperative day 1
Corneal staining	Fluorescein staining graded according to the Oxford grading scale.	Postoperative days 1, 7, 30 and 90
Global aesthetic improvement	Global Aesthetic Improvement Scale assessed by masked observers using standardized clinical photographs.	Postoperative days 1, 7, 30 and 90
Best corrected visual acuity	Best corrected visual acuity measured in logarithm of the minimum angle of resolution units.	Baseline, postoperative days 1, 7, 30 and 90

Collaborators and Investigators

• Sponsor: Fatma Poslu Karademir

Study record dates

Study Major Dates

• Study Start (Actual): June 23, 2025
• Primary Completion (Actual): November 28, 2025
• Study Completion (Actual): November 28, 2025

Study Registration Dates

• First Submitted: July 8, 2026
• First Submitted That Met QC Criteria: July 8, 2026
• First Posted (Actual): July 14, 2026

Study Record Updates

• Last Update Posted (Actual): July 14, 2026
• Last Update Submitted That Met QC Criteria: July 8, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Postoperative edema; Eyelid surgery; Upper eyelid blepharoplasty; Compression dressing; Postoperative ecchymosis; Split-eye design
• Other Study ID Numbers: BLF-25-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No