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Pre-operative trichiatic eyelash pattern predicts post-operative trachomatous trichiasis.
Gower, Emily W; Munoz, Beatriz; Rajak, Saul; Habtamu, Esmael; West, Sheila K; Merbs, Shannath L; Harding, Jennifer C; Alemayehu, Wondu; Callahan, E Kelly; Emerson, Paul M; Gebre, Teshome; Burton, Matthew J.
Afiliação
  • Gower EW; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, United States of America.
  • Munoz B; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America.
  • Rajak S; The Sussex Eye Hospital, Brighton, United Kingdom.
  • Habtamu E; London School of Hygiene & Tropical Medicine, London, United Kingdom.
  • West SK; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America.
  • Merbs SL; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America.
  • Harding JC; Helen Keller International, Dar es Salaam, Tanzania.
  • Alemayehu W; Berhan Public Health and Eye Care Consultancy, Addis Ababa, Ethiopia.
  • Callahan EK; The Carter Center, Atlanta, Georgia, United States of America.
  • Emerson PM; International Trachoma Initiative, Atlanta, Georgia, United States of America.
  • Gebre T; International Trachoma Initiative, Addis Ababa, Ethiopia.
  • Burton MJ; London School of Hygiene & Tropical Medicine, London, United Kingdom.
PLoS Negl Trop Dis ; 13(10): e0007637, 2019 10.
Article em En | MEDLINE | ID: mdl-31589610
ABSTRACT
IMPORTANCE Trichiasis surgery programs globally have faced high rates of poor surgical outcomes. Identifying correctable risk factors for improving long-term outcomes is essential for countries targeting elimination of trachoma as a public health problem.

OBJECTIVE:

To determine whether the location of trichiatic eyelashes prior to surgery influences development of post-operative trichiasis (PTT) within two years after surgery.

DESIGN:

Secondary data analysis of four randomized clinical trials evaluating methods to improve trichiasis surgery outcomes. These include the Surgery for Trichiasis, Antibiotics for Recurrence (STAR) trial, Partnership for Rapid Elimination of Trachoma (PRET-Surgery), absorbable versus silk sutures trial, and epilation versus surgery for minor trichiasis trial.

SETTING:

Primary trials were conducted in rural areas of Ethiopia and Tanzania. INTERVENTIONS OR EXPOSURES Trichiasis surgery performed with either the bilamellar tarsal rotation procedure or posterior lamellar rotation procedure. MAIN

OUTCOMES:

Prevalence of PTT within two years after surgery, location of trichiatic eyelashes pre-operatively and post-operatively.

RESULTS:

6,747 eyelids that underwent first-time trichiasis surgery were included. PTT rates varied by study, ranging from 10-40%. PTT was less severe (based on number of trichiatic eyelashes) than initial trichiasis for 72% of those developing PTT, and only 2% of eyelids were worse at follow up than pre-operatively. Eyelids with central only-trichiasis pre-operatively had lower rates of PTT than eyelids with peripheral only trichiasis in each of the three trials that included severe TT cases. 10% of eyelids with peripheral trichiasis pre-operatively that develop PTT have central TT post-operatively. CONCLUSIONS AND RELEVANCE Pre-operative central trichiasis is less likely than peripheral trichiasis to be associated with subsequent PTT. Regardless of type of surgery, surgeon skill levels, or pre-operative trichiasis severity, the presence of peripheral trichiasis pre-operatively is associated with higher rates of PTT. Making an incision that extends the length of the eyelid and adequately rotating the nasal and temporal aspects of the eyelid when suturing may help to minimize the chance of developing peripheral PTT. TRIAL REGISTRATION ClinicalTrials.gov PRET NCT00886015; Suture NCT005228560; Epilation NCT00522912.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tracoma / Pestanas / Triquíase / Complicações Cognitivas Pós-Operatórias Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tracoma / Pestanas / Triquíase / Complicações Cognitivas Pós-Operatórias Idioma: En Ano de publicação: 2019 Tipo de documento: Article