title: Recurrence of trachomatous trichiasis 17 years after bilamellar tarsal rotation procedure.
abstract: OBJECTIVE
  In 1989, World Health Organization consultant operated on trachomatous trichiasis (TT) cases in Dhakhiliya region of Oman. We evaluated their current ocular status.
  
  
  METHODS
  This was an historic cohort study.
  
  
  METHODS
  This study was conducted in an in-house setting. Ninety-one patients with TT who underwent operation by the bilamellar tarsal rotation procedure (BTR) were our study population. Their preoperative, operative, and immediate postoperative data were retrieved from the register. Staff members located and visited these patients. They examined the eyes and determined their visual, TT, and corneal status. They interviewed participants with a close-ended questionnaire to assess the quality of life and satisfaction for the TT services that were offered.
  
  
  RESULTS
  Sixty-three patients could be followed. Among 72 eyes that had undergone operation 17 years earlier, the recurrence rate was 47.2% (95% CI, 35.7-58.8). In 21 unoperated eyes (55%), TT was noted. The association of TT recurrence to age, gender, type of TT, conjunctivitis, and active trachoma was tested. The BTR for minor trichiasis was the risk factor for recurrence of TT (adjusted odds ratio, 3.9; 95% CI, 1.4-10.8).
  
  
  CONCLUSIONS
  The high recurrence rate of TT, 17 years after BTR surgery and high rates of TT in eyes that did not undergo surgical procedure earlier suggest that the causes of high recurrence should be identified and addressed. The ongoing pathologic condition of scarring of upper lids of both operated and unoperated eyes could be responsible for lid status after 17 years of BTR surgeries. High percentage of refusals because of long-term high recurrence could pose a challenge to reach the "elimination of blinding trachoma" by 2020.
authors.affiliation: Eye & Ear Health Care, Ministry of Health, Muscat, Oman. rajshpp@omantel.net.om
authors.forename: Rajiv
authors.initials: R
authors.lastname: Khandekar
authors.forename: Khalfan
authors.initials: K
authors.lastname: Al-Hadrami
authors.forename: Natarajan
authors.initials: N
authors.lastname: Sarvanan
authors.forename: Saleh
authors.initials: S
authors.lastname: Al Harby
authors.forename: Ali Jaffer
authors.initials: AJ
authors.lastname: Mohammed
mesh_terms: D005140:Eyelashes; D005141:Eyelid Diseases / Q000209:etiology* / Q000601:surgery; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006201:Hair Diseases / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D012008:Recurrence; D012307:Risk Factors; D014141:Trachoma / Q000209:etiology* / Q000601:surgery