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Trichiasis surgery in The Gambia: a 4-year prospective study.
- Source :
-
Investigative ophthalmology & visual science [Invest Ophthalmol Vis Sci] 2010 Oct; Vol. 51 (10), pp. 4996-5001. Date of Electronic Publication: 2010 May 26. - Publication Year :
- 2010
-
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. Although trichiasis surgery can reduce the risk of blindness, retrospective data suggest that long-term recurrence rates may be high. A 4-year prospective investigation of recurrent trichiasis was conducted in The Gambia.<br />Methods: Patients with trichiasis were examined at baseline, 6 months, 1 year, and 4 years after posterior lamellar tarsal rotation surgery. Conjunctival swabs for bacteriology and PCR for C. trachomatis were collected at baseline, 6 months, and 1 year.<br />Results: Three hundred fifty-six Gambian patients were enrolled at baseline and 266 were reassessed at 4 years (94% of surviving patients). The recurrence rates were 32%, 40%, and 41% at 6 months, 1 year, and 4 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.<br />Conclusions: Trichiasis recurrence rates were high, and most cases recurred within 6 months of surgery. The results suggest that there are important aspects of surgical technique and quality that should to be addressed. Persistent inflammation is strongly associated with recurrence at 4 years.
- Subjects :
- Aged
Anti-Bacterial Agents therapeutic use
Azithromycin therapeutic use
Chlamydia trachomatis genetics
Corneal Opacity diagnosis
Corneal Opacity microbiology
Eyelid Diseases diagnosis
Eyelid Diseases microbiology
Female
Gambia
Hair Diseases diagnosis
Hair Diseases microbiology
Humans
Male
Middle Aged
Polymerase Chain Reaction
Prospective Studies
Secondary Prevention
Trachoma diagnosis
Trachoma microbiology
Treatment Outcome
Visual Acuity
Chlamydia trachomatis isolation & purification
Eyelashes
Eyelid Diseases surgery
Hair Diseases surgery
Trachoma surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1552-5783
- Volume :
- 51
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Investigative ophthalmology & visual science
- Publication Type :
- Academic Journal
- Accession number :
- 20505197
- Full Text :
- https://doi.org/10.1167/iovs.10-5169