Trichiasis surgery in The Gambia: a four year prospective study.


Rajak, SN; Makalo, P; Sillah, A; Holland, MJ; Mabey, DC; Bailey, RL; Burton, MJ; (2010) Trichiasis surgery in The Gambia: a four year prospective study. Investigative ophthalmology & visual science. ISSN 0146-0404 DOI: https://doi.org/10.1167/iovs.10-5169

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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. Trichiasis surgery probably reduces the risk of blindness. However, retrospective data suggest that long-term recurrence rates may be high. We conducted a four-year prospective investigation of recurrent trichiasis in The Gambia. Methods. Patients with trichiasis were examined at baseline, six months, one and four years after posterior lamellar tarsal rotation surgery. Conjunctival swabs for bacteriology and PCR for C.trachomatis were collected at baseline, six months and one year. Results. We recruited 365 Gambian patients at baseline and re-assessed 266 at four years (94% of surviving patients). The recurrence rates were 32%, 40% and 41% at six months, one and four 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, most of which occurred within six months of surgery. This suggests that there are important aspects of surgical technique and quality that need to be addressed. Persistent inflammation was strongly associated with recurrence at four years.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Neglected Tropical Diseases Network
The International Centre for Evidence in Disability
International Centre for Eye Health
PubMed ID: 20505197
Web of Science ID: 282275500018
URI: http://researchonline.lshtm.ac.uk/id/eprint/3582

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