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Orbital FracturesPREVENTECTNCT07775417

A Trial to Evaluate Two Ectropion Preventive Measures Using the Subciliary Approach in Orbital Fracture Surgery.

A study testing Subciliary Approach, Lateral Canthopexy and Orbicularis Oculi Suspension in people with Orbital Fractures and Orbital Floor Fractures, run by Minia University.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to investigate whether preventive surgical techniques can reduce the incidence of lower eyelid ectropion after the subciliary approach in adult patients undergoing surgery for orbital fractures. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Orbital Fractures, Orbital Floor Fractures
What is being tested?
Subciliary Approach, Lateral Canthopexy and Orbicularis Oculi Suspension
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
No sites listed yet
Study dates
1 Sep 2026to 30 Nov 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Systemically healthy patients aged 18 years or older, with no history of chronic or uncontrolled systemic diseases.
  • Patients with primary orbital trauma requiring surgical treatment through a standardized subciliary approach, presenting with orbital floor fractures with or without associated lateral orbital rim fractures involving the lateral canthal tendon region, and without associated zygomaticomaxillary complex (ZMC) fractures.

Who cannot join

  • Secondary orbital trauma (revision cases or patients with previous orbital trauma).
  • Previous lower eyelid surgery.
  • Pre-existing eyelid malposition (ectropion or entropion) or other pre-existing lower eyelid or lateral canthal abnormalities.
  • Uncontrolled systemic conditions that may affect wound healing, eyelid integrity, or lower eyelid laxity, including uncontrolled diabetes mellitus, immunocompromised status, chronic corticosteroid therapy, or collagen vascular diseases.
  • Previous radiotherapy to the orbital or facial region.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Yasmin Abdelfattah, BDS contact

+20 1116104101

yasmin.a7med16@yahoo.com

Mohamed S. Elkhouly, PhD contact

+20 1002318399

mohammed.s.elkhouly@minia.edu.eg

About this study

Official title: A Comparative Clinical Trial Evaluating Preventive Techniques for Postoperative Ectropion Following the Subciliary Approach in Orbital Trauma.

The goal of this clinical trial is to investigate whether preventive surgical techniques can reduce the incidence of lower eyelid ectropion after the subciliary approach in adult patients undergoing surgery for orbital fractures.

The main questions it aims to answer are:

Read more

Do lateral canthopexy or orbicularis oculi suspension reduce the incidence of postoperative ectropion? Which preventive technique provides better postoperative lower eyelid outcomes?

Researchers will compare three groups: subciliary approach alone, subciliary approach with lateral canthopexy, and subciliary approach with orbicularis oculi suspension to investigate which approach is most effective in preventing postoperative ectropion.

Participants will undergo surgical treatment according to their assigned group and will attend scheduled postoperative follow-up visits for clinical evaluation of lower eyelid position and surgical outcomes.

Read the detailed description

Orbital fractures commonly require surgical reconstruction to restore orbital anatomy and function. The subciliary approach provides excellent surgical exposure but may be associated with postoperative lower eyelid malposition, particularly ectropion, which can affect both function and appearance. Several preventive surgical techniques, including lateral canthopexy and orbicularis oculi muscle suspension, have been proposed to reduce this complication; however, evidence comparing their effectiveness remains limited.

This prospective randomized controlled clinical trial will compare three treatment groups: subciliary approach, subciliary approach with lateral canthopexy, and subciliary approach with orbicularis oculi suspension. Participants will be followed postoperatively to evaluate the incidence of ectropion and other lower eyelid outcomes. The findings will provide evidence regarding the effects of these techniques on postoperative lower eyelid position and ectropion following orbital fracture repair.

The orbital fracture repair will be performed through a standardized subciliary approach in all study groups. According to randomization, participants will receive either lateral canthopexy, orbicularis oculi suspension, or no additional lower eyelid procedure. The specific surgical techniques, including suture placement, tissue fixation, suture material, tension, and periosteal fixation, will be standardized across participants within each intervention group. All surgical procedures will be performed by the same surgeon across all three study groups to ensure consistency of the surgical technique and minimize operator-related variability.

Postoperative Management: All participants in the three study groups will receive standardized postoperative management, including Frost suture, eyelid taping, eyelid massage, corticosteroid therapy, and postoperative dressing. The same postoperative management protocol will be applied to all treatment groups to ensure consistency of postoperative care.

Before randomization and surgery, all participants will undergo a standardized preoperative assessment of the lower eyelid and lateral canthal position. The assessment will include measurement of baseline margin reflex distance 2 (MRD2), evaluation of scleral show, lower eyelid position, canthal tilt, and lateral canthal position. Standardized clinical assessment of lower eyelid laxity will also be performed using the snap-back test and eyelid distraction test. Standardized preoperative photographs will be obtained using consistent patient positioning and standardized views to document baseline eyelid and lateral canthal anatomy.

Being tested
Subciliary Approach, Lateral Canthopexy, Orbicularis Oculi Suspension
Keywords
Orbital Fractures, Orbital Floor Fracture, Subciliary Approach, Ectropion, Lateral Canthopexy, Orbicularis Oculi Suspension, Lower Eyelid Malposition, Orbital Reconstruction, Oral and Maxillofacial Surgery, Randomized Controlled Trial
Medical subject headings
Orbital Fractures, Ectropion

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Subciliary ApproachProcedure or surgery

    Standardized subciliary approach for orbital fracture repair. The skin incision will be placed approximately 2 mm below the lower eyelid margin within a natural skin crease, extending from approximately 1 mm temporal to the inferior punctum toward the lateral canthal region. A stepped skin-muscle approach will be used, with the skin incision followed by inferior subcutaneous dissection and subsequent incision of the preseptal orbicularis oculi muscle approximately 7 mm inferior to the subciliary margin. Dissection will proceed to the infraorbital rim while maintaining the integrity of the orbital septum. The periosteum will be incised approximately 3-4 mm below the inferior orbital rim on its facial aspect to obtain surgical exposure.

  • Lateral CanthopexyProcedure or surgery

    Lateral Canthopexy Technique: A 4-0 polydioxanone (PDS) suture on a P2 needle will be placed through the periosteum of the inner aspect of the lateral orbital rim over Whitnall's tubercle at the desired height. The suture will then engage the medial end of the lateral canthal tendon and the lateral border of the lower eyelid tarsus in a vertical direction. The suture will be tied with the lower eyelid positioned at the desired height. Periosteal fixation will be used.

  • Orbicularis Oculi SuspensionProcedure or surgery

    A standardized orbicularis oculi suspension procedure performed in conjunction with the subciliary approach. Following the subciliary incision, the orbicularis oculi muscle is split 7 mm inferior to the subciliary margin while preserving pretarsal muscle function. The lateral edge of the preseptal orbicularis oculi muscle is bluntly dissected to the lateral orbital rim and suspended to the periosteum at the anchoring point using a Vicryl 5-0 or 6-0 horizontal mattress suture with appropriate tension.

Study groups in NCT07775417
Study groupRoleWhat they receive
Subciliary ApproachActive comparatorParticipants will undergo orbital fracture repair using the subciliary approach.
Receives: Procedure: Subciliary Approach
Subciliary Approach with Lateral CanthopexyExperimentalParticipants will undergo orbital fracture repair using the subciliary approach combined with lateral canthopexy. The effect of lateral canthopexy on postoperative lower eyelid position and the incidence of ectropion will be evaluated.
Receives: Procedure: Subciliary Approach; Procedure: Lateral Canthopexy
Subciliary Approach with Orbicularis Oculi SuspensionExperimentalParticipants will undergo orbital fracture repair using the subciliary approach combined with orbicularis oculi suspension. The effect of orbicularis oculi suspension on postoperative lower eyelid position and the incidence of ectropion will be evaluated.
Receives: Procedure: Subciliary Approach; Procedure: Orbicularis Oculi Suspension

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of postoperative lower eyelid ectropion

    The proportion of participants who develop postoperative lower eyelid ectropion after orbital fracture repair. Ectropion will be assessed clinically by an examiner blinded to treatment allocation using the Ectropion Grading Scale (EGS), a standardized grading system for assessing the severity of lower eyelid ectropion. The severity will be graded from Grade 0 (normal eyelid position) to Grade V (severe ectropion with associated complications). Standardized postoperative photographs will also be obtained using consistent patient positioning and standardized views at each assessment time point to facilitate comparison of postoperative lower eyelid position and ectropion severity over time.

    Measured: 1 week, 1 month, 3 months, and 6 months postoperatively

Secondary outcomes (6)
  1. Change in lower margin reflex distance 2 (MRD2) from baseline

    Change in lower margin reflex distance 2 (MRD2) from baseline will be measured clinically by an examiner blinded to treatment allocation. MRD2 will be defined as the distance, in millimeters, between the central corneal light reflex and the lower eyelid margin, measured with the patient in primary gaze using a standardized measurement technique. Standardized frontal photographs will also be obtained at each assessment time point using consistent patient positioning to facilitate documentation and evaluation of postoperative lower eyelid position.

    Measured: 1 week, 1 month, 3 months, and 6 months postoperatively

  2. Inferior scleral show

    The amount of inferior scleral show will be assessed clinically by an examiner blinded to treatment allocation and measured in millimeters as the visible scleral area between the lower eyelid margin and the inferior limbus in primary gaze. Standardized frontal photographs will also be obtained at each assessment time point to facilitate comparison of lower eyelid position over time.

    Measured: 1 week, 1 month, 3 months, and 6 months postoperatively

  3. Postoperative lower eyelid retraction

    The presence and severity of postoperative lower eyelid retraction will be assessed clinically by an examiner blinded to treatment allocation, based on inferior displacement of the lower eyelid margin relative to its baseline position. Assessment will be supported by standardized clinical measurements and photographs.

    Measured: 1 week, 1 month, 3 months, and 6 months postoperatively

  4. Ectropion severity

    The severity of postoperative lower eyelid ectropion will be assessed clinically by an examiner blinded to treatment allocation using the Ectropion Grading Scale (EGS), a standardized grading system ranging from Grade 0 (normal eyelid position) to Grade V (severe ectropion with associated complications). Standardized postoperative photographs will also be obtained to facilitate assessment of ectropion severity over time.

    Measured: 1 week, 1 month, 3 months, and 6 months postoperatively

  5. Subciliary scar assessment

    The subciliary surgical scar will be assessed clinically for visibility, quality, and the presence of hypertrophic scarring by an examiner blinded to treatment allocation. Standardized photographs will also be obtained to facilitate assessment of scar appearance.

    Measured: 1 month, 3 months, and 6 months postoperatively

  6. Patient satisfaction

    Patient-reported functional and aesthetic satisfaction following surgery will be assessed using a Visual Analogue Scale (VAS) ranging from 0 to 10. Patients will rate their functional satisfaction and aesthetic satisfaction separately, with 0 indicating complete dissatisfaction and 10 indicating complete satisfaction. The same assessment will be performed at each postoperative time point to allow comparison of patient-reported satisfaction over time and among the three treatment groups.

    Measured: 1 month, 3 months, and 6 months postoperatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Aug 2026
  2. Study start1 Sep 2026 (estimated)
  3. Primary completion31 Oct 2027 (estimated)
  4. Study completion30 Nov 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomly assigned in a parallel design to one of three intervention groups: subciliary approach alone, subciliary approach with lateral canthopexy, or subciliary approach with orbicularis oculi suspension. Outcomes will be compared between the groups during scheduled postoperative follow-up.
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07775417
Sponsor's protocol ID
OMFS-ECT-2026-01
Acronym
PREVENTECT
Status last verified
Aug 2026
First submitted
7 Aug 2026
Last updated
20 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared due to confidentiality and institutional ethical requirements.

Publications

  • Al-Moraissi E, Elsharkawy A, Al-Tairi N, Farhan A, Abotaleb B, Alsharaee Y, Oginni FO, Al-Zabidi A. What surgical approach has the lowest risk of the lower lid complications in the treatment of orbital floor and periorbital fractures? A frequentist network meta-analysis. J Craniomaxillofac Surg. 2018 Dec;46(12):2164-2175. doi: 10.1016/j.jcms.2018.09.001. Epub 2018 Sep 21.

    PubMed 30337055

Questions about this trial

What is this clinical trial studying?

A study testing Subciliary Approach, Lateral Canthopexy and Orbicularis Oculi Suspension in people with Orbital Fractures and Orbital Floor Fractures, run by Minia University.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 20 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Yasmin Abdelfattah, BDS (+20 1116104101, yasmin.a7med16@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of postoperative lower eyelid ectropion (time frame: 1 week, 1 month, 3 months, and 6 months postoperatively). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07775417, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Aug 2026.

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