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
It is now generally accepted that several locations in East and Southeast Asia,specifically the Republic of Korea,Japan,Singapore,China's Mainland,Hong Kong and Taiwan,have a high prevalence of myopia and potentia...It is now generally accepted that several locations in East and Southeast Asia,specifically the Republic of Korea,Japan,Singapore,China's Mainland,Hong Kong and Taiwan,have a high prevalence of myopia and potentially pathological high myopia(1-3).In fact,around 70-90%of students completing secondary schooling in these locations are now myopic(4-11),requiring some form of correction for good distance viewing.In many places,over half of the students are myopic and need correction by the end of primary school.In most of these locations,there has been a progressive development of education systems since the end of the Second World War,resulting in highly competitive systems,which produce educational outcomes that top the world in international surveys such as PISA and TIMSS(12).The data which illustrate these trends were published in recent review(2)and used as a figure in an influential news report in Nature on The Myopia Boom(1).展开更多
Background:Trichiasis recurrence following surgery is a serious problem for trachoma programs.Objective:To determine if postoperative treatment with azithromycin compared with topical tetracycline reduces recurrence u...Background:Trichiasis recurrence following surgery is a serious problem for trachoma programs.Objective:To determine if postoperative treatment with azithromycin compared with topical tetracycline reduces recurrence up to 1 year,and if azithromycin treatment of household members provides additional benefit compared with treating only the surgical patient.Design:A randomized,single-masked,clinical trial was conducted in Ethiopia.A total of 1452 patients with trichiasis were randomized 1:1:1 to the following 3 arms:single-dose(1 g)oral azithromycin alone,single-dose azithromycin for household members(20 mg/kg up to 1 g)plus the patient,or topical tetracycline(twice per day for 6 weeks).Main Outcome Measures:Trichiasis recurrence within 1 year following surgery.Results:The combined azithromycin groups had significantly fewer recurrences,6.9 of 100 person-years overall,compared with topical tetracycline,10.3 of 100 personyears(P=.047).There was no additional reduction in the arm that also treated household members,8.1 of 100 person-years,compared with treating the surgical patients alone,5.8 of 100 person-years(P=.19).Conclusions:In trachoma-endemic areas,a single dose ofazithromycin reduced postoperative trichiasis recurrence rates by one third compared with topical tetracycline.Application to Clinical Practice:In countries where azithromycin is part of the Trachoma Control Program,patients with trachomatous trichiasis should be treated postoperatively to prevent recurrence.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It is now generally accepted that several locations in East and Southeast Asia,specifically the Republic of Korea,Japan,Singapore,China's Mainland,Hong Kong and Taiwan,have a high prevalence of myopia and potentially pathological high myopia(1-3).In fact,around 70-90%of students completing secondary schooling in these locations are now myopic(4-11),requiring some form of correction for good distance viewing.In many places,over half of the students are myopic and need correction by the end of primary school.In most of these locations,there has been a progressive development of education systems since the end of the Second World War,resulting in highly competitive systems,which produce educational outcomes that top the world in international surveys such as PISA and TIMSS(12).The data which illustrate these trends were published in recent review(2)and used as a figure in an influential news report in Nature on The Myopia Boom(1).
文摘Background:Trichiasis recurrence following surgery is a serious problem for trachoma programs.Objective:To determine if postoperative treatment with azithromycin compared with topical tetracycline reduces recurrence up to 1 year,and if azithromycin treatment of household members provides additional benefit compared with treating only the surgical patient.Design:A randomized,single-masked,clinical trial was conducted in Ethiopia.A total of 1452 patients with trichiasis were randomized 1:1:1 to the following 3 arms:single-dose(1 g)oral azithromycin alone,single-dose azithromycin for household members(20 mg/kg up to 1 g)plus the patient,or topical tetracycline(twice per day for 6 weeks).Main Outcome Measures:Trichiasis recurrence within 1 year following surgery.Results:The combined azithromycin groups had significantly fewer recurrences,6.9 of 100 person-years overall,compared with topical tetracycline,10.3 of 100 personyears(P=.047).There was no additional reduction in the arm that also treated household members,8.1 of 100 person-years,compared with treating the surgical patients alone,5.8 of 100 person-years(P=.19).Conclusions:In trachoma-endemic areas,a single dose ofazithromycin reduced postoperative trichiasis recurrence rates by one third compared with topical tetracycline.Application to Clinical Practice:In countries where azithromycin is part of the Trachoma Control Program,patients with trachomatous trichiasis should be treated postoperatively to prevent recurrence.
