Background: Subciliary incision, a common technique for traumatic facial repair, associates with lower eyelid scar contracture and malpositioning. Despite proposed management techniques like eyelid massage, the efficacy of post-operative massage remains unexplored in preventing and treating these issues.

Objective: To assess the effectiveness of lower eyelid massage in preventing lower eyelid scar contracture and malposition following the subciliary approach for traumatic facial repair, compared to standard care without massage.

Materials and Methods: A randomized controlled trial enrolled patients with traumatic facial fractures slated for subciliary approach repair. Patients were randomly allocated to the lower eyelid massage as the experimental group or standard care as the control group. The massage group received post-operative instructions. Data on demographics, injury profiles, lower eyelid scar contracture as graded by the grading of lower eyelid scar contracture (GLESCO) criteria, eyelid malpositioning, comfort scores, and complications were gathered over a 6-month follow-up.

Results: The present study included 59 patients, with 30 in the massage group and 29 in the control group. There were no significant differences in demographic characteristics, injury profiles, or complications between the two groups. Post-operative assessments revealed the massage group exhibited a trend towards lower GLESCO grades with an average decrease of 0.72 grade per week (95% CI –1.46 to 0.02, p=0.058) and lower eyelid malpositioning grades with an average decrease of 0.49 grade per week (95% CI –1.03 to 0.05, p=0.073) compared to the control group. However, there was no significant difference in comfort scores between the two groups with an average difference of 0.18 score per week (95% CI –1.08 to 1.45, p=0.775).

Conclusion: Lower eyelid massage demonstrated potential benefits in preventing lower eyelid scar contracture following traumatic facial repair. However, its impact on eyelid malpositioning and comfort scores was not statistically significant in the present study. Further study with larger sample sizes is warranted to validate these findings.

Trial registration: ClinicalTrials.gov, NCT06311318

Keywords: Subciliary incision; Subciliary approach; Lower eyelid massage; Facial fracture; Scar contracture; Eyelid malposition; Ectropion

DOI: 10.35755/jmedassocthai.2024.4.13967

Received 21 August 2023 | Revised 11 March 2024 | Accepted 12 March 2024