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May 1992

A Controlled Trial of Surgery for Trachomatous Trichiasis of the Upper Lid

Author Affiliations

From the Dana Center for Preventive Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University, Baltimore, Md (Dr Reacher and Ms Muñoz); the Ministry of Health, Muscat, Oman (Drs Alghassany and Elbualy); Sultan Qaboos University, Al Khod, Oman (Drs Daar and Elbualy); and the Department of Ophthalmology, University of Melbourne, Australia (Dr Taylor).

Arch Ophthalmol. 1992;110(5):667-674. doi:10.1001/archopht.1992.01080170089030

• The effectiveness of commonly used procedures to correct trachomatous trichiasis of the upper lid was examined in a clinical trial in Oman. Lids were graded as having minor trichiasis (five or fewer lashes), major trichiasis (more than five lashes), and defective lid closure. Randomly allocated surgery specific for lid grade was completed in 384 lids, of which 369 (96%) were followed up once or twice approximately 9 and 21 months after surgery. The definition of operative success included no evidence of trichiasis and complete lid closure. Tarsal rotation was the most effective operation and was successful in 80% of cases of minor trichiasis, compared with success rates of 29% for electrolysis and 18% for cryoablation. Tarsal rotation was successful in 77% of cases of major trichiasis, compared with a 41% success rate for tarsal advance and rotation. Surgery for major trichiasis produced a significant improvement in visual acuity in operated vs nonoperated fellow eyes in a regression model incorporating the between-eyes correlation of visual acuity.

Dawson CR, Jones BR, Tarizzo ML. Guide to Trachoma Control . Geneva, Switzerland: World Health Organization; 1981:16,22, 29,40-47.
Reacher MH, Huber MJE, Canagaratnam R, Alghassany A.  A trial of surgery for trichiasis of the upper lid from trachoma . Br J Ophthalmol . 1990;74:109-113.Article
Darougar S. Assignment Report: Control and Prevention of Blindness in Oman . Geneva, Switzerland: World Health Organization; 1982. Publication EM/PBL/15;EM/ophthal/21;EM/Oma/PBL/001/.
Jones BR, Barras TC, Hunter PA, Darougar S.  Neglected lid deformities causing progressive corneal disease . Trans Ophthalmol Soc U K . 1976;96:45-51.
Roper-Hall MJ. Stallard's Eye Surgery . 6th ed. Bristol, England: John Wright and Sons Ltd; 1980:150-151.
Johnson RLC, Collin JRO.  Treatment of trichiasis with a lid cryoprobe . Br J Ophthalmol . 1985;69:267-270.Article
Wies FA. Spastic entropion. Trans Am Acad Ophthalmol Otolaryngol . 1955;59:503-506.
Ballen PH.  A simple procedure for the relief of trichiasis and entropion of the upper lid . Arch Ophthalmol . 1964;72:239-240.Article
Trabut G.  Entropion-trichiasis en Afrique du Nord . Arch d'Ophtalmol NS . 1949;9:701-707.
Collin JRO.  Entropion and trichiasis . In: A Manual of Systematic Eyelid Surgery . New York, NY: Churchill-Livingstone Inc; 1983:7-27.
Meinert C.  Randomization and the mechanics of treatment masking . In: Clinical Trials: Design, Conduct, and Analysis . New York, NY: Oxford University Press Inc; 1986:90-112.
Peart DA, Hill JC.  Cryosurgery for trichiasis in black patients . Br J Ophthalmol . 1986;70:712-714.Article
Seigel DG.  Cox regression analysis in clinical research . Arch Ophthalmol . 1990;108:888-889.Article
Muñoz A, Rosner B, Carey V.  Regression analysis in the presence of heterogeneous intraclass correlations . Biometrics . 1986;42:653-658.Article
Sullivan JH, Beard C, Bullock JD.  Cryosurgery for treatment of trichiasis . Am J Ophthalmol . 1976;82:117-121.
Sullivan JH.  The use of cryotherapy for trichiasis . Trans Am Acad Ophthalmol Otolaryngol . 1977;83:OP708-OP712.
Baylis HI, Cies WA, Kamin DF.  Overcorrections of the Wies procedure . Trans Ophthalmol Soc U K . 1976;96:458-461.
West SK, Muñoz B, Turner VM, Mmbaga BBO, Taylor HR.  The epidemiology of trachoma in Central Tanzania . Int J Epidemiol . 1991;20:1088-1092.Article
Duke-Elder S, MacFaul PA.  Motor disorders and deformations of the eyelids, II: abnormalities of the palpebral aperture . In: Duke-Elder S, ed. System of Ophthalmology . St Louis, Mo: Mosby-Year Book; 1974;13(pt 1):576-577.
Fox S. Ophthalmic Plastic Surgery . 5th ed. New York, NY: Grune & Stratton; 1976:313-349.
Delaney MR, Rogers PA.  A simplified cryotherapy technique for trichiasis and distichiasis . Aust J Ophthalmol . 1984;12:163-166.Article
Rice DR, Kersten RC, Al-Hazzaa S.  Cryotherapy for trichiasis in trachoma . Arch Ophthalmol . 1989;107:1180-1182.Article
Babalola OE.  Correction of trachomatous entropion/trichiasis in Kaduna: an assessment of two simplified methods . East Afr Med J . 1988;65:525-531.
Casanovas J, Mawas E.  La chrirurgerie oculaire en terrain trachomateux . Rev Int Trach Pathol Ocul Trop Subtrop Sante Publique . 1961;38:1-180.
Fox S.  Cicatricial entropion of the upper lid . Am J Ophthalmol . 1964;57:379-382.
Nyunt Win W.  Surgery for trachoma in Burma . Br J Ophthalmol . 1976;63:113-116.Article
Reacher MH, Pe'er J, Rapoza PA, Whittum-Hudson J, Taylor HR.  T cells and trachoma: their role in cicatricial disease . Ophthalmology . 1991;98:334-341.Article