Aim: To examine the association between epilation and corneal opacity (CO) among trichiasis patients presenting for surgery. Methods: Cross sectional data from the STAR trial were utilised. Patients presenting for tri...Aim: To examine the association between epilation and corneal opacity (CO) among trichiasis patients presenting for surgery. Methods: Cross sectional data from the STAR trial were utilised. Patients presenting for trichiasis surgery inWolayta Zone, Ethiopia,were evaluated for current trichiasis status. Number of inturned lashes, evidence of epilation, level of entropion, trichiasis duration, and CO were collected. The primary outcome was prevalence of CO, stratified by entropion and epilation status. Results: Approximately 10%of eyes with mild entropion had CO, regardless of epilation status. Among eyes with moderate entropion, epilated eyes were less likely to have CO than nonepilated eyes (21%v 34%p=0.002). The same association was seen in eyes with severe entropion: 43%of epilated eyes while 74%of non-epilated eyes had CO (p< 0.0001). Presence of CO increased with age. Adjusted models showed a protective effect of epilation in eyes with moderate or severe entropion (OR: 0.51; 95%CI: 0.32 to 0.83 and OR: 0.24; 95%CI: 0.13 to 0.45, respectively). Among eyes with mild entropion there was no difference in the prevalence of CO comparing eyes that were epilated with those that were not epilated. Conclusion: Entropion was the most significant predictor of CO. Cross sectional associations suggest that epilation may not be helpful for eyes with mild entropion, but may offer protection against CO in eyes with moderate to severe entropion. Epilation should not be a substitute for trichiasis surgery, however, as 43%of eyes with severe entropion that were epilated still had CO.展开更多
Objective: To evaluate the pattern of recurrence of trachomatous trichiasis (T T) after bilamellar tarsal rotation surgery for trachoma. Design: Observational cohort. Participants: Three hundred eighty-four participan...Objective: To evaluate the pattern of recurrence of trachomatous trichiasis (T T) after bilamellar tarsal rotation surgery for trachoma. Design: Observational cohort. Participants: Three hundred eighty-four participants having at least 1 eye that had undergone a single TT surgery a minimum of 18 months before June 20 01. The 630 study eyes were divided equally between left (311) and right (319) e yes. Methods: Patients living in Central Tanzania were identified from surgical lists. Participants were screened for recurrence of TT, including evidence of ep ilation, after surgery. Main Outcome Measures: Detailed information on the locat ion of recurrence was collected, including number of lashes touching the globe a nd location of trichiatic lashes (nasal, central, or temporal). Results: One hun dred seventy-six eyes had evidence of TT recurrence (28%), including 23 eyes h aving recently undergone epilation. In eyes without epilation, left eyes had a h igher rate of recurrence than right eyes (32%vs. 25%; P=0.05). Among eyes with recurrence originating from 1 location, recurrence was highest centrally (40%) . Right eyes had nasal recurrence more often than temporal recurrence (33%vs. 2 0%). Left eyes had temporal recurrencemore often than nasal recurrence (41%vs. 24%). Conclusions: Recurrence of TT after surgery is more common in the left e ye and on the left side of the eyelid. The surgical procedure is more difficult to perform on the right side of the eyelid by a right-handed surgeon. This diff iculty may lead to an unintentional change in surgical technique on the right, w hich may result in lower recurrence on that side.展开更多
PURPOSE. The World Health Organization recommends tri- chiasis surgery to prevent blindness caused by trachoma; however, recurrence is common. Risk factors for recurrence have not been widely studied, particularly in ...PURPOSE. The World Health Organization recommends tri- chiasis surgery to prevent blindness caused by trachoma; however, recurrence is common. Risk factors for recurrence have not been widely studied, particularly in trachoma hyperendemic areas. METHODS. Three hundred ninety- four persons with trichiasis in Tanzania were examined. Participants had undergone surgery >18 months before the study. Trichiasis recurrence and active trachoma at study visit were assessed. Ocular swabs were collected and tested for Chlamydia trachomatis. Household members were examined for active trachoma. RESULTS. Of the surgical eyes, 28% had recurrence;40% of patients had recurrence in one or both eyes. Rates did not vary by time since surgery. Eye- level recurrence rates varied significantly across districts, ranging from 16% to 38% . Current chlamydial infection among surgical cases was low (6% ) and was not associated with recurrence. Recurrence was associated with tarsal conjunctival inflammation (OR: 2.4; 95% confidence interval [CI]: 1.6- 3.8) and residence in the Kongwa district (OR: 2.3; 95% CI: 1.2- 4.6). CONCLUSIONS. Recurrence after trichiasis surgery is high, suggesting that vigilant follow- up in surgical cases is needed to reduce blindness. Recurrence is associated with evidence of inflammation in the tarsal conjunctiva, although it is not clear whether the inflammation contributes to recurrence, or is a result of the recurrence. Longitudinal studies of trichiasis patients after surgery are needed.展开更多
文摘Aim: To examine the association between epilation and corneal opacity (CO) among trichiasis patients presenting for surgery. Methods: Cross sectional data from the STAR trial were utilised. Patients presenting for trichiasis surgery inWolayta Zone, Ethiopia,were evaluated for current trichiasis status. Number of inturned lashes, evidence of epilation, level of entropion, trichiasis duration, and CO were collected. The primary outcome was prevalence of CO, stratified by entropion and epilation status. Results: Approximately 10%of eyes with mild entropion had CO, regardless of epilation status. Among eyes with moderate entropion, epilated eyes were less likely to have CO than nonepilated eyes (21%v 34%p=0.002). The same association was seen in eyes with severe entropion: 43%of epilated eyes while 74%of non-epilated eyes had CO (p< 0.0001). Presence of CO increased with age. Adjusted models showed a protective effect of epilation in eyes with moderate or severe entropion (OR: 0.51; 95%CI: 0.32 to 0.83 and OR: 0.24; 95%CI: 0.13 to 0.45, respectively). Among eyes with mild entropion there was no difference in the prevalence of CO comparing eyes that were epilated with those that were not epilated. Conclusion: Entropion was the most significant predictor of CO. Cross sectional associations suggest that epilation may not be helpful for eyes with mild entropion, but may offer protection against CO in eyes with moderate to severe entropion. Epilation should not be a substitute for trichiasis surgery, however, as 43%of eyes with severe entropion that were epilated still had CO.
文摘Objective: To evaluate the pattern of recurrence of trachomatous trichiasis (T T) after bilamellar tarsal rotation surgery for trachoma. Design: Observational cohort. Participants: Three hundred eighty-four participants having at least 1 eye that had undergone a single TT surgery a minimum of 18 months before June 20 01. The 630 study eyes were divided equally between left (311) and right (319) e yes. Methods: Patients living in Central Tanzania were identified from surgical lists. Participants were screened for recurrence of TT, including evidence of ep ilation, after surgery. Main Outcome Measures: Detailed information on the locat ion of recurrence was collected, including number of lashes touching the globe a nd location of trichiatic lashes (nasal, central, or temporal). Results: One hun dred seventy-six eyes had evidence of TT recurrence (28%), including 23 eyes h aving recently undergone epilation. In eyes without epilation, left eyes had a h igher rate of recurrence than right eyes (32%vs. 25%; P=0.05). Among eyes with recurrence originating from 1 location, recurrence was highest centrally (40%) . Right eyes had nasal recurrence more often than temporal recurrence (33%vs. 2 0%). Left eyes had temporal recurrencemore often than nasal recurrence (41%vs. 24%). Conclusions: Recurrence of TT after surgery is more common in the left e ye and on the left side of the eyelid. The surgical procedure is more difficult to perform on the right side of the eyelid by a right-handed surgeon. This diff iculty may lead to an unintentional change in surgical technique on the right, w hich may result in lower recurrence on that side.
文摘PURPOSE. The World Health Organization recommends tri- chiasis surgery to prevent blindness caused by trachoma; however, recurrence is common. Risk factors for recurrence have not been widely studied, particularly in trachoma hyperendemic areas. METHODS. Three hundred ninety- four persons with trichiasis in Tanzania were examined. Participants had undergone surgery >18 months before the study. Trichiasis recurrence and active trachoma at study visit were assessed. Ocular swabs were collected and tested for Chlamydia trachomatis. Household members were examined for active trachoma. RESULTS. Of the surgical eyes, 28% had recurrence;40% of patients had recurrence in one or both eyes. Rates did not vary by time since surgery. Eye- level recurrence rates varied significantly across districts, ranging from 16% to 38% . Current chlamydial infection among surgical cases was low (6% ) and was not associated with recurrence. Recurrence was associated with tarsal conjunctival inflammation (OR: 2.4; 95% confidence interval [CI]: 1.6- 3.8) and residence in the Kongwa district (OR: 2.3; 95% CI: 1.2- 4.6). CONCLUSIONS. Recurrence after trichiasis surgery is high, suggesting that vigilant follow- up in surgical cases is needed to reduce blindness. Recurrence is associated with evidence of inflammation in the tarsal conjunctiva, although it is not clear whether the inflammation contributes to recurrence, or is a result of the recurrence. Longitudinal studies of trichiasis patients after surgery are needed.
