Effect of trichiasis surgery on visual acuity outcomes in Ethiopia

Arch Ophthalmol. 2009 Nov;127(11):1505-10. doi: 10.1001/archophthalmol.2009.278.

Abstract

Objectives: To determine the effect of trichiasis surgery on visual acuity.

Methods: A total of 439 participants in the Surgery for Trichiasis, Antibiotics to Prevent Recurrence (STAR) trial had visual and subjective concerns measured before and 6 months after surgery. Trichiasis surgery was performed in at least 1 eye by integrated eye care workers. Visual acuity was measured using illiterate E versions of Early Treatment Diabetic Retinopathy Study charts with standardized, forced-choice procedures. Improvement was defined as improvement in visual acuity greater than 1 line (5 letters).

Results: The mean improvement in visual acuity for the eyes that had surgery was 0.129 logMAR units (P < .001). Surgery was associated with improvement in visual acuity compared with no surgery (odds ratio, 1.68; 95% confidence interval, 1.04-2.70). Independent predictors of visual acuity improvement in the eyes that had surgery included the number of lashes touching the globe prior to surgery and baseline visual acuity. Among patients, 93.8% described significant pain and 90.4% significant photophobia at baseline compared with only 1.4% and 0.9%, respectively, following surgery.

Conclusions: Surgery to correct trichiasis appears to provide significant visual acuity improvement as well as a decrease in subjective concerns in patients with trachomatous trichiasis.

Trial registration: clinicaltrials.gov Identifier: NCT00347776.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Oral
  • Adult
  • Age Distribution
  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / therapeutic use
  • Ethiopia / epidemiology
  • Eyelashes*
  • Eyelid Diseases / surgery*
  • Female
  • Hair Diseases / surgery*
  • Humans
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures*
  • Sex Distribution
  • Single-Blind Method
  • Tetracycline / therapeutic use
  • Trachoma / drug therapy
  • Trachoma / epidemiology
  • Visual Acuity / physiology*

Substances

  • Anti-Bacterial Agents
  • Azithromycin
  • Tetracycline

Associated data

  • ClinicalTrials.gov/NCT00347776