What it means for a patient
- A compression dressing reduced bruising on the first day after upper eyelid surgery.
- From one week on, the dressed and undressed eyelids showed no significant difference on any measure.
- The dressing did not change pain and did not harm the cornea in this trial.
- The authors conclude the benefit is small and short-lived, that routine dressing may not be necessary, and that the choice should fit each patient's needs.
- Limits: 56 patients, and the trial was registered retrospectively.
Why this paper matters
It tested compression dressing after upper blepharoplasty by comparing the two eyelids of each patient, and found only a short-lived effect on bruising.
Overview
Surgeons differ on whether to place a compression dressing after upper eyelid blepharoplasty. In this observer-blinded, randomized trial, each patient had a compression dressing on one eyelid and no dressing on the other. The authors measured pain, changes to the eye surface, swelling, bruising and appearance.
Findings
- 56 patients, 112 eyelids, bilateral upper blepharoplasty between June and August 2025.
- One eyelid per patient received a compression dressing; the other received no dressing.
- Masked observers graded swelling and bruising on days 1, 7, 30 and 90.
- Appearance was rated with the Global Aesthetic Improvement Score; pain with a visual analog scale; comfort by which side the patient preferred.
- Day 1 bruising was significantly lower on the dressing side (unadjusted p = 0.002; Holm-adjusted p = 0.012).
- Day 1 swelling was lower (unadjusted p = 0.012) and aesthetic scores higher (unadjusted p = 0.046) on the dressing side.
- Neither of those two differences stayed significant after correction for multiple comparisons (adjusted p = 0.060 and 0.138).
- No significant difference in any measure on days 7, 30 or 90.
- Corneal staining scores were similar on both sides at every visit, and no corneal erosions occurred.
- Day 1 pain scores were similar (p = 0.977).
- The trial was registered after the fact (ClinicalTrials.gov NCT07701265, July 8, 2026).
Terms
- Upper eyelid blepharoplasty: surgery to remove excess skin, and sometimes fat, from the upper eyelids.
- Compression dressing: a pressure bandage placed over the wound after surgery.
- Ecchymosis: bruising.
- Edema: swelling.
- Observer-blinded: the people grading results did not know which eyelid had the dressing.
- Holm-Bonferroni correction: a statistical adjustment that lowers the chance of false findings when many comparisons are made.
- Corneal staining: a dye test that shows damage to the clear front surface of the eye.
- Visual analog scale: a line on which patients mark their level of pain.
- Retrospectively registered: entered in a trial registry after the study began.