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Invest Ophthalmol Vis Sci. 2010 Oct;51(10):4996-5001. doi: 10.1167/iovs.10-5169. Epub 2010 May 26.

Trichiasis surgery in The Gambia: a 4-year prospective study.

Author information

1
London School of Hygiene and Tropical Medicine, London, UK. saul.rajak@lshtm.ac.uk

Abstract

PURPOSE:

Trachoma is the leading infectious cause of blindness. Conjunctival Chlamydia trachomatis infection causes scarring, entropion, trichiasis, and blinding corneal opacification. Worldwide, there are 8 million people with trichiasis. Although trichiasis surgery can reduce the risk of blindness, retrospective data suggest that long-term recurrence rates may be high. A 4-year prospective investigation of recurrent trichiasis was conducted in The Gambia.

METHODS:

Patients with trichiasis were examined at baseline, 6 months, 1 year, and 4 years after posterior lamellar tarsal rotation surgery. Conjunctival swabs for bacteriology and PCR for C. trachomatis were collected at baseline, 6 months, and 1 year.

RESULTS:

Three hundred fifty-six Gambian patients were enrolled at baseline and 266 were reassessed at 4 years (94% of surviving patients). The recurrence rates were 32%, 40%, and 41% at 6 months, 1 year, and 4 years, respectively. At 4 years, 30% of patients had bilateral trichiasis and 21% had bilateral corneal opacity. Recurrence was associated with severe conjunctival inflammation and severe trichiasis (>10 lashes) at baseline.

CONCLUSIONS:

Trichiasis recurrence rates were high, and most cases recurred within 6 months of surgery. The results suggest that there are important aspects of surgical technique and quality that should to be addressed. Persistent inflammation is strongly associated with recurrence at 4 years.

PMID:
20505197
PMCID:
PMC3066607
DOI:
10.1167/iovs.10-5169
[Indexed for MEDLINE]
Free PMC Article

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