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

Barr, Kieran; Essex, Rohan W.; Liu, Susie; Henderson, Timothy

doi:10.1111/ceo.12197

Cited by 8 publications

(4 citation statements)

References 28 publications

(68 reference statements)

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“…In their retrospective study, Barr et al found that the recurrence rates for TT treated by both BLTR and ALR showed no statistically significant difference. However, they found that in cases that had equal follow-up periods for both procedures, recurrence in ALR group is less [ 20 ]. Madarosis, persistent abnormal lid appearance, and recurrence are the common complications associated with ALR while overcorrection, granuloma formation, and notching ischemia of the lid margin and defective lid closure have also been more reported with tarsotomy in BLTR and PLTR [ 18 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Short Term Outcome of Anterior Lamellar Reposition in Treating Trachomatous Trichiasis

Ahmed

Abdelbaky

2015

Journal of Ophthalmology

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Purpose. To evaluate the outcome of anterior lamellar reposition (ALR) in treating trachomatous trichiasis. Methods. Patients with trachomatous trichiasis or entropion with short tarsus were treated by ALR between February 2009 and November 2013. This included splitting of the lid margin behind the aberrant lash line to separate the lid lamellae. The anterior lamella was recessed and fixated using 4/0 silk sutures. The extra lashes and their routes were excised. Sutures were removed by the 3rd week and patients completed 6 months of follow-up. Recurrence of ≤5 lashes was treated by electrolysis. Results. The study included 752 eyelids (445 patients; 58.4% females, 41.6% males), mean age 53.2 ± 6.9 y. 179 (25.1%) lids had entropion while 287 (64.5%) patients had corneal affection. By the third week, 2.66% lid had trichiasis while 30.8% had no rubbing lashes. By the 6th month, 14.9% of lids showed recurrence while 66.1% were completely cured (CI = 0.63–0.69) and 19% had partial success (CI = 0.16–0.21). Abnormal lid appearance persisted in 2.66% and 12.9% required another surgery. Conclusion. ALR is a good option for treating trachomatous trichiasis especially without cicatricial entropion. Excision of dysplastic lashes is thought to augment the surgical outcome.

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Section: Discussionmentioning

confidence: 99%

Short Term Outcome of Anterior Lamellar Reposition in Treating Trachomatous Trichiasis

Ahmed

Abdelbaky

2015

Journal of Ophthalmology

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“…To move the posterior lamella inferiorly and make up for the degree of lid retraction, several authors advocated dissecting the upper lid retractors from the tarsus during UCE surgery. 12 , 16 Barr et al 19 reasoned that the failure to execute concurrent levator recession was the cause of the high recurrence rate (21%), which was reported in their study after ALR. However, we believe that supra tarsal fixation combined with blepharoplasty addressed this issue and prevented the high recurrence rate according to our results, where the success rate in our study was observed in 129 (90.2%) at the 9th month postoperative.…”

Section: Discussionmentioning

confidence: 88%

Modified Anterior Lamellar Recession for All Grades of Upper Eyelid Trachomatous Cicatricial Entropion

Ibrahim,

Tharwat,

Khalil

et al. 2023

OPTH

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Purpose This study aims to assess the combination of anterior lamellar recession (ALR) with blepharoplasty, suprasternal fixation, and internal eyelash bulb extirpation of aberrant lashes posteriorly located in patients with any grade of upper eyelid trachomatous cicatricial entropion. Patients and Methods We reviewed the clinical data of eighty-six patients (143 eyelids) including age, gender, systemic medical illnesses, and comprehensive ophthalmological assessment. Eyelid evaluation was recorded, including laterality, previous surgical technique used, possible trichiasis etiology, abnormality of the lid margin, tarsal plate consistency (shrinkage or loosening), skin fold overhanging, laxity of the pretarsal skin, margin reflex distance 1 (MRD1), lagophthalmos, and lid retraction. The success rate was assessed at 3, 6, 9, and 12 months postoperative. Results The success rate was 97.2% in the third month, which decreased significantly to 92.3% in the 6th month and 90.2% in the 9th month (P = 0.01, and 0.001 respectively). In the 9th month, we had fourteen failed cases. All of them were submitted for a second intervention. Three underwent electrolysis, four cases underwent re-internal bulb extirpation, four cases underwent the same procedure, and three cases underwent epilation. The success of the failed cases after the second intervention was significantly associated with the type of reintervention (P = 0.03), in which all of them succeed except two cases that underwent epilation. Kaplan-Meier analysis showed that the mean recurrence time in our study was 6.8 months (95% CI = 5.8–7.7 months). Conclusion This study showed the combination of ALR with blepharoplasty, suprasternal fixation, and cauterization or internal bulb extirpation of posteriorly located lashes procedure resulted in a high success rate in patients with any form of UCE with no increase in incidence or degree of lagophthalmos associated with UCE.

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“…Surgical correction of trichiasis is an integral part of the WHO effort to eliminate blindness from trachoma by the year 2020. However, the recurrence rates following surgery for trichiasis have been reported to be disappointingly high [ 6 ].…”

Section: Effectiveness Of Funding In Organizations Working To Eliminamentioning

confidence: 99%

Social Sciences for the Prevention of Blindness

Goldschmidt

2015

Trop.Med.Health

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Organizations working for the elimination of Chlamydia-triggered blindness (trachoma) follow the WHO SAFE strategy (surgery for trichiasis, antibiotics, face washing and environmental changes) with the aim to achieve a minimum of 80% of children with clean faces in endemic communities, mass treatment covering the whole district with trachoma rates of 10% or more and surveillance plans. Trachoma recurrence that is common after implementing the SAFE strategy 3, 5 or even 7 times evidence that the cognitive processes requiring assimilation and integration of knowledge did not register with parents, caretakers and children. Moreover, repeated awareness campaigns to improve hygiene did not systematically produce irreversible changes of behavior in neglected populations. In view of this evidence, the rational behind mass drug administration as the mainstay of preventable blindness elimination demands a wider scope than simple mathematical models. The reluctance to see disappointing outcomes that leads to repeated interventions may suggest from a sociologic point of view that the strategies are products of those evaluating the activities of those who fund them and vice versa. A similar articulation emerges for reciprocal interactions between researchers and those judging the pertinence and quality of their work. So far, the lack of autocritic elimination strategy approaches may expose inbred circles that did not properly grasp the fact that antibiotics, trichiasis surgery and education limited to improvement of hygiene are inefficient if not associated with long-term basic educational actions in schools.

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

Abstract: 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.

Cited by 8 publications

References 28 publications

Short Term Outcome of Anterior Lamellar Reposition in Treating Trachomatous Trichiasis

Short Term Outcome of Anterior Lamellar Reposition in Treating Trachomatous Trichiasis

Modified Anterior Lamellar Recession for All Grades of Upper Eyelid Trachomatous Cicatricial Entropion

Social Sciences for the Prevention of Blindness

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