Trichiasis in cicatricial ocular surface disease: a multi-center comparison of electroepilation versus eyelash resection outcomes.

PURPOSE: To evaluate the outcomes of trichiasis (excluding entropion) management in non-trachomatous cicatricial ocular surface diseases. METHODS: This is a multicenter, retrospective study of 59 patients with trichiasis who were managed using two different techniques: electroepilation using radiofrequency (RF) cautery and eyelash resection. The assessed outcomes were residual trichiasis at 6 weeks, 6, and 12 months of follow-up and the number of procedures needed. RESULTS: 41 patients (90 eyelids) underwent electroepilation, and 18 (41 eyelids) were managed with eyelash resection. All patients belonged to either Indian or Japanese ethnicity. Most patients in both groups had Stevens-Johnson Syndrome (63.4% vs. 88.9%). The mean age (43.2 vs. 46 years), disease duration (122 vs. 192.4 months), median trichiasis grade (2 vs. 2), and involvement of upper eyelids (53/90 vs. 23/41) were similar in the two groups. At six weeks, 48.9% of eyelids that underwent electroepilation had no trichiasis, and recurrences were managed with repeat electroepilation (6 eyelids) and mucous membrane grafting (10 eyelids), and 35 eyelids opted for manual epilation, giving 67.8% success at a mean follow-up of 20 months. The eyelash resection group had 75.6% success at 6 months, and recurrences were managed using lid splitting and eyelash resection, resulting in 100% success at a mean follow-up of 79 months. More interventions were needed in the electroepilation group compared to eyelash resection. CONCLUSION: Eyelash resection of the trichiatic eyelashes achieves a better success rate than electroepilation in cicatricial ocular surface disorders. Following electroepilation, one needs multiple interventions to resolve trichiasis.

Perceptions of ophthalmologists on the impact of trachoma in Egypt: a mixed-methods, nationwide survey.

PURPOSE: Understanding the perception and practices of ophthalmologists for trachoma is important to develop interventions aimed at disease elimination in Egypt. The survey investigated: (1) the views and practice patterns of Egyptian ophthalmologists for trachoma and (2) the influence of geographic location, setting, and years of practice on ophthalmologists' perceptions. METHODS: A questionnaire sent to ophthalmologists currently working in Egypt collected information on: (1) demographics, (2) caseload and practice patterns for trachoma, (3) 13 Likert scale questions regarding the current state of trachoma, and (4) two open-ended written response questions. RESULTS: Of the 500 recipients, 194 ophthalmologists participated. 98% of the respondents reported seeing trachoma patients in their practice. 28.8% agreed that trachoma is currently an active health problem in Egypt, with ophthalmologists in public practice having significantly higher agreement scores compared to private practitioners (p = 0.030). Rural ophthalmologists were significantly more likely to agree that a targeted trachoma control program is needed in their location of practice compared to their urban counterparts (p < 0.001). Open-ended questions revealed recurrent themes, including the rural distribution of trachoma patients and the high volume of patients with corneal opacity. CONCLUSION: Ophthalmologists' experiences with trachoma in Egypt differed based on practice setting, years in practice, and location, and the overall perception of the impact of the disease remains low. However, there was widespread agreement that trachoma is present in communities across the country. Practitioners in rural areas and in the public sector shared a disproportionate burden of the trachoma caseload. The perspectives of such ophthalmologists must be emphasized in decision-making related to trachoma interventions.

A comparative study of conventional intermarginal split lamella with labial mucous membrane graft versus sutureless procedure using fibrin sealant to manage major trichiasis.

OBJECTIVE: In the intermarginal split lamella with labial mucous membrane graft procedure to manage major trichiasis, the graft is usually sutured in the receptor bed using 6-0 polyglactin sutures. We aimed to compare the use of fibrin sealant to seal the graft to the receptor bed versus the conventional technique using sutures. METHODS: This is a retrospective comparative study of patients who underwent conventional intermarginal split lamella with labial mucous membrane graft or sutureless procedure using fibrin sealant (Tisseel, Baxter Healthcare Corp) between 2016 and 2021. Etiology of the trichiasis, procedure duration, postoperative discomfort and edema, complications, and follow-up period were extracted from these patients' charts. RESULTS: Twenty-seven eyelids from 19 patients underwent the procedure: twelve patients underwent the sutureless procedure, while seven underwent the conventional procedure. Mean follow-up was 8.4 ± 2.9 months and 13.7 ± 6.5 months for the sutureless and conventional groups, respectively. Patients who underwent the sutureless procedure reported no postoperative foreign body sensation, while 71.4% of patients who underwent the conventional procedure reported some degree of ocular discomfort. In the sutureless group, operating time and postoperative edema were significantly reduced. Labial mucous membrane graft dehiscence was observed in one eyelid (8.3%) on the first postoperative day in the sutureless group. No dehiscence was observed in the conventional technique group. CONCLUSION: The use of fibrin sealant showed to be a good alternative to conventional absorbable sutures. Advantages include expedited operating time, decreased postoperative discomfort, and expedite postoperative recovery.

[Large foreign bodies inside the orbit and maxillary sinus (clinical observation)]. / Krupnye inorodnye tela glaznitsy i verkhnechelyustnoi pazukhi (klinicheskoe nablyudenie).

The great variety of orbital traumas can surprise and challenge specialists attempting to cure its consequences with the best possible outcome. This article presents a clinical case of a patient diagnosed with cicatricial deformity of the free edge and trichiasis of the upper eyelid in the lateral angle area, keratopathy, enophthalmos on the left side; posttraumatic defect of the inferior orbital wall; multiple foreign bodies in the orbit and maxillary sinus on the left side. Patient examination included conventional ophthalmological study methods, as well as multislice computed tomography with 3D-reconstruction. Surgical treatment required involvement of an ophthalmologist, an otorhinolaryngologist and a maxillofacial surgeon. The first stage of surgical treatment addressed the deformity of the lateral part of the upper eyelid margin including resection of its fragment, trichiasis surgery, and lateral canthoplasty. In the second stage, the multidisciplinary team of surgeons removed foreign bodies through combined subciliary and endonasal access with placement of a mandibular autograft onto the inferior orbital wall. Radiological examination should be done in all patients with trauma to the orbital area in order to detect latent injuries. When choosing a treatment strategy, specialists should be aware of trauma complicity and necessity to enlist a multidisciplinary medical team. Patients should be informed that sometimes the consequences of the trauma may not be treated completely.

The application of electrolysis of depigmented hair using a trichiasis electrolyzer combined with single hair follicle transplantation for the treatment of vitiligo-associated leukotrichia.

Leukotrichia is one of the difficulties of vitiligo treatment. Hair follicle transplantation is an efficient method to treat vitiligo-associated leukotrichia. A trichiasis electrolyzer, commonly used for treating trichiasis, can be used to damage and remove the depigmented hair follicles. To evaluate the efficacy of the electrolysis of depigmented hair using a trichiasis electrolyzer combined with single hair follicle transplantation for the treatment of vitiligo-associated leukotrichia. A total of 15 patients with stable vitiligo-associated eyebrow and eyelash leukotrichia were enrolled from Department of Dermatology, Hangzhou Third People's Hospital between January 2020 and January 2021. All patients were treated using a trichiasis electrolyzer combined with single hair follicle transplantation. The patients were followed up at the first week, the first month, the third month, and the sixth month after surgery. The texture and growth state of the transplanted hair were observed, and the number of surviving transplanted follicles and regenerating depigmented follicles were recorded. The transplanted hair grew as expected with natural shape. No local infection or obvious scar was observed. Most of the depigmented hair in the lesion area re-pigmented and only a few depigmented hairs regenerated. The average survival rate of the transplanted hair follicles was 71.6%, and the average regeneration rate of the depigmented hair was 11.6%. The electrolysis of depigmented hair using a trichiasis electrolyzer combined with single hair follicle transplantation was an effective and safe method to treat vitiligo-associated leukotrichia.

Systematic review of the incidence of post-operative trichiasis in Africa.

BACKGROUND: Surgery for trichiasis is one of the pillars of the World Health Organization's strategy for global elimination of trachoma as a public health problem. A high incidence of post-operative trichiasis or other poor surgical outcomes could jeopardize these efforts. In this review, we aimed to summarize the reported incidence of post-operative trichiasis and other poor outcomes of trichiasis surgery in Africa. METHODS: We conducted a systematic literature search using PubMed, Academic Search Premier, Africa-Wide Information, CINAHL and Health Source Nursing through EBSCOhost, Web of Science, and the Cochrane Central Register of Controlled Trials. Reference lists of included studies were also reviewed to identify further potentially relevant publications. All observational and interventional studies that measured post-operative trichiasis in Africa as an outcome of trichiasis surgery were included. RESULTS: Thirty-five papers reporting on 22 studies (9 interventional,13 observational; total 13,737 participants) met the inclusion criteria. The reported incidence of post-operative trichiasis in the included studies ranged from 2% (at 6 weeks after bilamellar tarsal rotation) to 69% (at 3 weeks after anterior lamellar repositioning). The incidence varied by surgical procedure, study design, and length of follow-up. CONCLUSION: Trichiasis surgical outcomes should be improved. National trachoma programmes could benefit from identifying and adopting strategies to improve the performance and quality of their surgical service.

Surgical management of bilateral, upper and lower eyelid entropion in 27 Shar Pei dogs, using the Stades forced granulation procedure of the upper eyelid only.

Aims: To evaluate the outcome of surgical management of entropion of the upper and lower eyelids in Shar Pei dogs which had previously undergone temporary palpebral tacking, using the Stades forced granulation procedure of the upper eyelid only.Methods: Medical records were retrospectively searched to identify Shar Pei dogs referred for bilateral entropion of both the lower and upper eyelids, and that were treated with the forced granulation procedure of the upper eyelid only. Dogs were included if they had previously undergone unsuccessful temporary palpebral tacking and had at least three follow-up examinations in the 30 days following surgery.Results: Twenty-seven Shar Pei dogs with a median age of 7.9 (min 4, max 24) months were included in the study. Before surgery, all dogs showed signs of severe ocular discomfort with bilateral keratitis and visual deficit due to blepharospasm, enophthalmos and protrusion of the third eyelid. In 13/54 eyes, keratitis was associated with a corneal ulcer. When re-examined 4 weeks after surgery, correction of the upper eyelid entropion and associated trichiasis resolved ocular signs in 50/54 eyes. Mild bilateral lower entropion remained in two dogs postoperatively, which underwent revision surgery with the Hotz-Celsus technique. There were no cases of long-term recurrence of entropion or ocular irritation in the 38 eyes (19 dogs) which were re-examined 1 year after surgery.Conclusion and clinical relevance: The forced granulation procedure performed on the upper eyelid only was effective for correction of entropion in the Shar Pei dogs included in this study. In our experience, it is preferable to operate on the upper eyelid alone, rather than attempting to correct upper and lower entropion during the same surgical operation. The dog can then be reassessed a few weeks later to determine whether the lower entropion is anatomical or secondary to the severe blepharospasm resulting from the painful ocular irritation.

Understanding the spatial distribution of trichiasis and its association with trachomatous inflammation-follicular.

BACKGROUND: Whilst previous work has identified clustering of the active trachoma sign "trachomatous inflammation-follicular" (TF), there is limited understanding of the spatial structure of trachomatous trichiasis (TT), the rarer, end-stage, blinding form of disease. Here we use community-level TF prevalence, information on access to water and sanitation, and large-scale environmental and socio-economic indicators to model the spatial variation in community-level TT prevalence in Benin, Cote d'Ivoire, DRC, Guinea, Ethiopia, Malawi, Mozambique, Nigeria, Sudan and Uganda. METHODS: We fit binomial mixed models, with community-level random effects, separately for each country. In countries where spatial correlation was detected through a semi-variogram diagnostic check we then fitted a geostatistical model to the TT prevalence data including TF prevalence as an explanatory variable. RESULTS: The estimated regression relationship between community-level TF and TT was significant in eight countries. We estimate that a 10% increase in community-level TF prevalence leads to an increase in the odds for TT ranging from 20 to 86% when accounting for additional covariates. CONCLUSION: We find evidence of an association between TF and TT in some parts of Africa. However, our results also suggest the presence of additional, country-specific, spatial risk factors which modulate the variation in TT risk.

Trachoma in Yunnan province of southwestern China: findings from trachoma rapid assessment.

BACKGROUND: To understand the situation of active trachoma among children aged 6 to 8 years old and scarring trachoma among those aged 15 and over in Yunnan Province, South-western China. METHODS: A rapid assessment of trachoma was conducted to determine the presence or absence of trachoma in Yunnan. Through risk assessment, 9 sites in 8 suspected trachoma epidemic counties were selected. Trachoma Rapid Assessment was conducted in these areas afterwards. Within each sites, 50 students from grade one in local primary school and adults aged 15 and above with suspected scarring trachoma were examined by survey teams. RESULTS: A total of 450 children aged 6-8 years and 160 adults aged 15 and above were screened in 9 sites of 8 counties. Only 1 case of active trachoma was found. Detection rate of active trachoma in children was 0.2%(1/450) in all sites and 2% (1/50)in Pingbian County. Out of 150 adults only 1 case of TT and 1 case of CO were found in all the highest at risk communities. People with scarring trachoma were aged over 60 years. CONCLUSIONS: The active trachoma was rarely seen and trachoma is unlikely to be a significant public health problem in Yunnan Province, South-western China.

Prevalence of trachomatous trichiasis in Australia: the National Eye Health Survey.

IMPORTANCE: Australia is the only developed country to still have pockets of endemic trachoma. The research provides up-to-date, population-based prevalence data of later complications of trachoma amongst a national sample of Indigenous adults. BACKGROUND: To report the prevalence of trachomatous trichiasis (TT) in Indigenous Australians aged 40 years and older. DESIGN: Population-based cross-sectional study. PARTICIPANTS: A total of 1738 (41% male) Indigenous Australians aged 40 years or older, living amongst 30 randomly selected Australian sites, stratified by remoteness. METHODS: Anterior segment examination was performed and trachoma grading for the presence of TT and corneal opacification (CO) was conducted using the WHO (WHO) simplified grading system. MAIN OUTCOME MEASURES: Prevalence of TT. RESULTS: A total of three (0.17%) participants had TT, and there were no confirmed cases of trachomatous CO in the NEHS. All three participants with TT were female and aged 40 years or older. Although they had likely spent their childhoods in more remote areas, two of the three confirmed cases resided in an urban and outer regional area at the time of their examinations. CONCLUSIONS AND RELEVANCE: Our data are in line with ongoing national trachoma surveillance reports that suggest the prevalence of late sequences of trachoma appear to be decreasing in Australia.

Efficacy of Inverted "V" Release Surgery in the Correction of a Special Type of Epicanthus.

OBJECTIVE: To evaluate the efficacy of a new correction method (inverted "V" release surgery) for epicanthus as a cause of congenital entropion/trichiasis in the lower eyelid. METHODS: From May 2014 to May 2017, 60 eyes of 30 patients (13 male and 17 female patients, with the age of 6.85 ± 4.52 years underwent inverted "V" release surgery to correct epicanthus. The incision in the epicanthus and entropion was continuous. Lower eyelid entropion/trichiasis was corrected by a two-layered suture. We separately assessed the width of the palpebral fissure, exposed ratio of the lacrimal caruncle, eyelash direction, and incision scar at one and 6 months after surgery. RESULTS: All patients were followed up for 6-18 months. At 6 months after surgery, the palpebral fissure width of all patients was extended by 3-4 mm. The ratio of the exposed lacrimal caruncle was enhanced from 0.24 ± 0.22 to 0.75 ± 0.08. All patients presented with natural inner canthal angles, and their eyelashes clearly extended outward, with a 100% total effective rate. The inner canthal incision scars in 83% of patients were invisible 6 months after surgery. CONCLUSION: Based on our experience, both functionality and aesthetics can be obtained by using inverted "V" release surgery to correct a special type of epicanthus that aggravates congenital entropion/trichiasis in the lower eyelid. Thus, this technique is suitable for clinical application. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Outcomes of two surgical techniques for major trichiasis treatment.

The purpose of this article is to analyze the outcomes of two surgical techniques to treat major trichiasis. A retrospective chart review of 67 patients (89 eyelids) with major trichiasis was performed who underwent surgical treatment using one of two techniques: intermarginal split lamella with graft (ISLG group) or lid lamella resection (LLR group). There were 30 lids in the ISLG group with mean patient age of 71.8 years and 63.3% were females. There were 59 lids in the LLR group with mean patient age of 72.5 years and 52.5% were female. The minimum postoperative follow up was six months. Statistical analysis included descriptive measures, Goodman association test for contrasts between and within multinomial populations and nonparametric Mann-Whitney test for comparison between groups. P < 0.05 was considered statistically significant. The underlying causes of trichiasis were blepharitis (37.07%), chronic meibomitis (21.3%), multiple causes (20.2%), ectropion (11.2%), actinic keratosis (6.7%), or prior ocular surgery (3.3%). Postoperatively, in the ISLG group, there were 20% lids with complete success, 50% underwent laser or electrolysis, 16.7% required further surgery, and 13.3% were unsuccessful. Postoperatively, in the LLR group, there were 47.5% eyelids with complete success, 46.7% underwent laser or electrolysis, 6.8% required further surgery, and 5.1% were unsuccessful. There was a higher statistical chance of complete success with LLR (P < 0.05). LLR is superior to ISLG surgery for the treatment of major trichiasis. There is a greater chance of success with LLR and it is technically simpler.

Population-based prevalence survey of follicular trachoma and trachomatous trichiasis in the Casamance region of Senegal.

BACKGROUND: Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. We conducted the first population-based trachoma prevalence survey in the Casamance region of Senegal to enable the Senegalese National Eye Care Programme (NECP) to plan its trachoma control activities. The World Health Organization (WHO) guidelines state that any individual with trachomatous trichiasis (TT) should be offered surgery, but that surgery should be prioritised where the prevalence is >0.1%, and that districts and communities with a trachomatous inflammation, follicular (TF) prevalence of ≥10% in 1-9 year-olds should receive mass antibiotic treatment annually for a minimum of three years, along with hygiene promotion and environmental improvement, before re-assessing the prevalence to determine whether treatment can be discontinued (when TF prevalence in 1-9 year-olds falls <5%). METHODS: Local healthcare workers conducted a population-based household survey in four districts of the Bignona Department of Casamance region to estimate the prevalence of TF in 1-9 year-olds, and TT in ≥15 year-olds. Children's facial cleanliness (ocular and/or nasal discharge, dirt on the face, flies on the face) was measured at time of examination. Risk factor questionnaires were completed at the household level. RESULTS: Sixty communities participated with a total censused population of 5580 individuals. The cluster-, age- and sex-adjusted estimated prevalence of TF in 1-9 year-olds was 2.5% (95% Confidence Interval (CI) 1.8-3.6) (38/1425) at the regional level and <5% in all districts, although the upper 95%CI exceeded 5% in all but one district. The prevalence of TT in those aged ≥15 years was estimated to be 1.4% (95%CI 1.0-1.9) (40/2744) at the regional level and >1% in all districts. CONCLUSION: With a prevalence <5%, TF does not appear to be a significant public health problem in this region. However, TF monitoring and surveillance at sub-district level will be required to ensure that elimination targets are sustained and that TF does not re-emerge as a public health problem. TT surgery remains the priority for trachoma elimination efforts in the region, with an estimated 1819 TT surgeries to conduct.

Comparison of trichiasis recurrence after primary bilamellar tarsal rotation or anterior lamellar repositioning surgery performed for trachoma.

BACKGROUND: To compare the trichiasis recurrence rate following bilamellar tarsal rotation or anterior lamellar repositioning, performed as primary surgery for trachomatous trichiasis. DESIGN: Retrospective consecutive case series. PARTICIPANTS: All cases of trachomatous trichiasis undergoing primary surgical correction at Alice Springs Hospital, Alice Springs, Northern Territory, Australia, between 1 June 2001 and 11 June 2011 were included. METHODS: Retrospective chart review. Key baseline, operative and outcome details were collected from the notes. MAIN OUTCOME MEASURE: Recurrent trichiasis was defined as one or more lashes touching the cornea, resulting in recurrent symptoms of trichiasis and warranting further surgery in the opinion of the treating ophthalmologist. RESULTS: Sixty-seven BTR and eighteen ALR procedures were performed, with BTR being performed from 2001 to 2008, and ALR from 2008 to 2011. The mean follow-up times were significantly different for the BTR group (1654 days) and for the ALR group (673 days)(P < 0.001). Kaplan-Meier survival analysis did not reveal any significant differences in recurrence rate between the two procedures overall (P = 0.935). Analysis of the 2008 calendar year (the only year where both procedures were performed and therefore had equal follow-up times) suggested that ALR might have a lower recurrence rate (1/10 ALR recurrences vs. 4/6 BTR recurrences, P = 0.181). CONCLUSIONS: The results do not demonstrate a difference in the recurrence rate between the two techniques. Inconsistent follow times however leave uncertainty in this result, and a larger prospective randomised study is warranted to address this question.

Ectopia cilia with pedigree analysis: Second case report in the world.

We present a case of ectopia cilia in a 28-year-old male patient. Ectopia cilia was were seen in the outer third of left upper eyelid. The patient's maternal grandfather also had ectopia cilia of the left upper eyelid as reported by the patient's mother. Ectopia cilia is a rare condition seen in humans. Only 12 cases of ectopic cilia in humans have been reported so far in the world. The present case of ectopia cilia is the second case report in the world with pedigree analysis.

The prevention and management of postoperative trachomatous trichiasis: A systematic review.

Among ocular infections, trachoma is the main cause of blindness. Repeated conjunctival Chlamydia trachomatis infections lead to trichiasis, corneal opacification, and visual impairment. Surgery is often needed to relieve discomfort and preserve vision; however, a high postoperative trachomatous trichiasis (PTT) rate has been observed in various settings. We wanted to know why, whether PTT rates could be reduced, and how to manage the PTT that occurs. We performed a search of the literature. Of 217 papers screened, 59 studies were identified for inclusion as potentially relevant, the majority having been excluded for not directly concerning PTT in humans. Preventing PTT is a major challenge. Only one published trial, the STAR trial in Ethiopia, has reported a cumulative PTT rate <10% one year after surgery. The literature on the management of PTT is sparse. Though no PTT management guidelines are available, high-quality surgery with a low rate of unfavorable outcomes for PTT patients is likely to require enhanced training of a smaller group of highly-skilled surgeons. Based on the surgical complexity and the authors' own experience, the pathway for patients suffering from PTT should be studied further for improvement.

Progress towards the elimination of trachoma in Nigeria.

Trachoma is targeted for elimination as a public health problem worldwide by 2030. In Nigeria, elimination activities are implemented at the local government area (LGA) level. They started in 2002 by conducting baseline population-based prevalence surveys (PBPSs), which continued in a systematic manner with engagement from the Global Trachoma Mapping Project in 2013, and subsequently Tropical Data. The results led to the development of Nigeria's first trachoma action plan and its subsequent revision with additional information. Following 449 baseline PBPSs, 122 LGAs had an active trachoma prevalence above the elimination threshold, requiring interventions, while 231 LGAs required community-based interventions for trichiasis management. By 2021, >34 million antibiotic treatments had been provided in 104 LGAs, with 89 LGAs eliminating active trachoma. Nationally, water and sanitation coverages increased by 3% and 18%, respectively, in 7 y. Systematic trichiasis case finding and management were carried out in 231 LGAs, resulting in the management of 102 527 people. Fifty-four LGAs decreased trichiasis prevalence unknown to the health system to <0.2% in persons ≥15 y of age. Where this elimination prevalence threshold was reached, trichiasis services were transitioned to routine eye/healthcare systems. Such progress relied on strong leadership and coordination from the national trachoma program and tremendous support provided by partners. Attaining elimination of trachoma as a public health problem in Nigeria by 2030 is feasible if funding support is sustained.

Trichiasis removal using dermatological punch: A case report.

Entropion, a common malposition of the eyelid, can lead to trichiasis and corneal damage. This article presents a clinical case in which, following initial surgery to correct entropion, the use of a dermatological punch was chosen to definitively eliminate persistent trichiasis. This relatively unknown yet effective approach proved to be a quick and straightforward alternative with positive outcomes, emphasizing the importance of considering innovative approaches to recurrent challenges in clinical practice.

Reducing tension step by step in epicanthus and lower eyelid incision for treating cilial entropion in children: A case series analysis.

OBJECTIVE: To evaluate the surgical outcomes of a modified technique for treating congenital cilial entropion in children, which involves reducing tension step by step in the epicanthus and lower eyelid incision. METHODS: The observational group consisted of 153 pediatric patients (81 males and 72 females) who were treated using the modified technique, whereas the control group included 124 patients (68 males and 56 females) who were treated using the rotating suture surgery. All the participants were bilateral. Surgical outcomes were classified as good, fair, or poor, and the recurrence rate, scar condition, inferior eyelid position, and patient satisfaction were also assessed. RESULTS: The mean follow-up period was 9.13 ± 3.50 months (range: 3-14 months) for the observational group and 6.93 ± 4.51 months (range: 3-14 months) for the control group. In the observational group, surgical success with "good" outcomes was achieved in 300 eyes (98.04%), compared to 224 eyes (90.32%) in the control group. No recurrence occurred in the observational group, whereas the recurrence rate in the control group was 4.43%. Postoperative scar formation was mild in the observational group. The average scar score was 1.27 ± 0.96 in the observational group and 2.70 ± 0.99 in the control group, with a statistically significant difference (P < 0.001). Neither overcorrection nor postoperative ectropion was observed in both groups. CONCLUSION: The modified technique effectively corrected medial entropion and trichiasis in the lower eyelid, resulting in stable postoperative outcomes, mild scar formation, quick recovery, flexible eyelid motility, and stable ocular surface. Therefore, it can be widely applied to children with congenital entropion and trichiasis.

Ocular manifestations and outcomes of OPMD- a report from the national IsrOPMD registry.

PURPOSE: This study aims to describe the ocular manifestations, treatment, and prognosis of OPMD patients registered in the national Israel OPMD(IsrOPMD) registry. METHODS: Data was prospectively collected from patients referred to the IsrOPMD registry from January 2022 to March 2023. This included patient demographics, medical and ocular history, eye exams, eyelid evaluations, visual field exams, and orthoptic evaluations. RESULTS: 30 patients (15 males, mean age 53 years) were treated in the ocular OPMD clinic, predominantly of Bukhari descent (86.6%). The mean visual acuity was 0.06 logMAR. Twenty-one patients (70%) had eye movement problem, mostly in horizontal gaze. 6(20%) patients' complaint about diplopia. Ptosis surgery was performed in 21(70%) patients, with 17(56.7%) patients underwent frontalis sling surgery and 4(13.3%) patients undergoing levator advancement. The mean Margin reflex distance (MRD1) improved post-surgery (2.28 mm vs. 1.58 mm), but 11(36.6%) patients required more than one ptosis surgery. CONCLUSIONS: The study contributes valuable insights into the ocular aspects of OPMD. It reveals that OPMD patients often experience a range of ocular symptoms, such as ptosis, abnormalities in eye movements, strabismus, and potentially diplopia, which can significantly impact their quality of life. The findings underscore the importance of regular ophthalmological follow-up for these patients to address these symptoms effectively. The study is significant in contributing to the limited but growing knowledge about the ocular manifestations of OPMD and the management of these symptoms to improve the quality of life for patients suffering from this condition.