title: Community-based transconjunctival marginal rotation for cicatricial trachoma in Indians from the Upper Rio Negro basin.
abstract: The objective of the present study was to describe, for the first time in Brazil, the use by a non-ophthalmologist of a community-based marginal rotation procedure by a posterior approach in the indigenous population from the Upper Rio Negro basin. Seventy-three upper eyelids of 46 Indians (11 males and 35 females) with cicatricial upper eyelid entropion and trichiasis were operated in the Indian communities using a marginal rotational procedure by a posterior approach by a non-ophthalmologist physician who had general surgery experience but only an extremely short period (one week) of ophthalmic training. Subjects were reevaluated 6 months after surgery. Results were classified according to the presence and location of residual trichiasis and symptoms were assessed according to a three-level subjective scale (better, worse or no change). Fifty-six eyelids (76.7%) were free from trichiasis, whereas residual trichiasis was observed in 17 eyelids (23.3%) of 10 subjects. In these cases, trichiasis was either lateral or medial to the central portion of the lid. Of these 10 patients, only 4 reported that the surgery did not improve the irritative symptoms. We conclude that marginal rotation by a posterior approach is an effective and simple procedure with few complications, even when performed by non-specialists. Due to its simplicity the posterior approach is an excellent option for community-based upper eyelid entropion surgery.
authors.affiliation: Federação das Organizações dos Indios do Rio Negro, Sao Gabriel da Cachoeira, AM, Brazil.
authors.forename: O E
authors.initials: OE
authors.lastname: Soares
authors.forename: A A V
authors.initials: AA
authors.lastname: Cruz
mesh_terms: D001938:Brazil; D002921:Cicatrix / Q000601:surgery*; D004774:Entropion / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D007199:Indians, South American; D008297:Male; D012399:Rotation; D014141:Trachoma / Q000601:surgery*; D016896:Treatment Outcome