Effect of trichiasis surgery on visual acuity outcomes in Ethiopia.
OBJECTIVE
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.


BACKGROUND
clinicaltrials.gov Identifier: NCT00347776.
Woreta
Tinsay A
TA
Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21287, USA.
Munoz
Beatriz E
BE
Gower
Emily W
EW
Alemayehu
Wondu
W
West
Sheila K
SK
D000284:Administration, Oral; D000328:Adult; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D005002:Ethiopia / Q000453:epidemiology; D005140:Eyelashes; D005141:Eyelid Diseases / Q000601:surgery*; D005260:Female; D006201:Hair Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D017678:Sex Distribution; D016037:Single-Blind Method; D013752:Tetracycline / Q000627:therapeutic use; D014141:Trachoma / Q000188:drug therapy / Q000453:epidemiology; D014792:Visual Acuity / Q000502:physiology*
D000900:Anti-Bacterial Agents; D017963:Azithromycin; D013752:Tetracycline