Fat prolapse and tear trough deformity, indicative of lower eyelid aging, are increasingly prevalent in younger patients. Transconjunctival lower blepharoplasty (TCLB) is a suitable treatment for this demographic; however, traditional techniques have limitations that affect their simplicity and effectiveness.

We conducted a prospective, randomized controlled trial to systematically compare the modified TCLB technique with traditional TCLB in two groups, with the aim of evaluating its therapeutic efficacy through direct methodological comparison.

This study, conducted from August 2020 to August 2022, included 40 patients with lower eyelid fat prolapse and tear trough deformity, randomly assigned to either the experimental or control group. The experimental group underwent a modified TCLB technique, while the control group received traditional TCLB combined with orbital fat release. Postoperative outcomes were evaluated by comparing baseline data, surgical duration, changes in the vertical distance from the lowest point of the tear trough to the pupil, Barton tear trough classification, and the Global Aesthetic Improvement Scale(GAIS) between the two groups.

Preoperative baseline data showed no significant differences between the two groups. However, the experimental group had a significantly shorter surgical duration. Post-treatment comparisons revealed superior maintenance of surgical outcomes in the experimental group compared to the control group.

This prospective, comparative, and randomized study demonstrates the favorable therapeutic effects of the modified TCLB technique.