Routine bilamellar tarsal rotation surgery for trachomatous trichiasis: short-term outcome and factors associated with surgical failure.
OBJECTIVE
To determine risk factors for early failure of the bilamellar tarsal rotation procedure in trachomatous trichiasis.


METHODS
This was a prospective study in which the bilamellar tarsal rotation procedure was performed on 638 eyelids in Menofiya governorate in Egypt over a 4-year period. An analysis was performed to determine the incidence of early surgical failure (defined as one or more lashes touching the eyeball) after 8 weeks and to determine the risk factors for these failures.


RESULTS
Follow-up data were available on 599 eyes at 8 to 10 weeks after surgery. Considering all eyes, failure (one or more lashes touching the eyeball) was noted in 98 eyes (16.4%). Failure was associated with preoperative corneal staining (RR, 3.27; 95% CI, 2.34 to 4.57), preoperative corneal opacity (RR, 1.64; 95% CI, 1.15 to 2.34), the use of silk sutures (RR, 54.82; 95% CI, 7.72 to 389.4), and the use of 4 or more sutures (RR, 1.24; 95% CI, 1.04 to 1.48).


CONCLUSIONS
The finding that specific sutures or needles was associated with early failure of the bilamellar tarsal plate rotation procedure for trachomatous trichiasis was unexpected and deserves further study.
University of Cairo, Cairo, Egypt. eeltoukhy@yahoo.com
Essam
E
El Toukhy
Susan
S
Lewallen
Paul
P
Courtright
D019882:Blepharoplasty / Q000379:methods*; D005140:Eyelashes; D005141:Eyelid Diseases / Q000382:microbiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006201:Hair Diseases / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014141:Trachoma / Q000382:microbiology / Q000601:surgery*; D017211:Treatment Failure; D016896:Treatment Outcome