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Routine Bilamellar Tarsal Rotation Surgery for Trachomatous Trichiasis: Short-Term Outcome and Factors Associated With Surgical Failure

2006; Lippincott Williams & Wilkins; Volume: 22; Issue: 2 Linguagem: Inglês

10.1097/01.iop.0000203494.49446.60

1537-2677

Essam El Toukhy, Susan Lewallen, Paul Courtright,

Reproductive tract infections research

In Brief Purpose: To determine risk factors for early failure of the bilamellar tarsal rotation procedure in trachomatous trichiasis. Methods: This was a prospective study in which the bilamellar tarsal rotation procedure was performed on 638 eyelids in Menofiya governorate in Egypt over a 4-year period. An analysis was performed to determine the incidence of early surgical failure (defined as one or more lashes touching the eyeball) after 8 weeks and to determine the risk factors for these failures. Results: Follow-up data were available on 599 eyes at 8 to 10 weeks after surgery. Considering all eyes, failure (one or more lashes touching the eyeball) was noted in 98 eyes (16.4%). Failure was associated with preoperative corneal staining (RR, 3.27; 95% CI, 2.34 to 4.57), preoperative corneal opacity (RR, 1.64; 95% CI, 1.15 to 2.34), the use of silk sutures (RR, 54.82; 95% CI, 7.72 to 389.4), and the use of 4 or more sutures (RR, 1.24; 95% CI, 1.04 to 1.48). Conclusions: The finding that specific sutures or needles was associated with early failure of the bilamellar tarsal plate rotation procedure for trachomatous trichiasis was unexpected and deserves further study. Demographic and technical variations in high-volume eyelid surgery for trachoma are analyzed.