title: Impact of Trichiasis surgery on physical functioning in Ethiopian patients: STAR trial.
abstract: OBJECTIVE
  To evaluate the physical functioning of Ethiopian trichiasis surgery patients before and 6 months after surgery.
  
  
  METHODS
  Nested cohort study.
  
  
  METHODS
  This study was nested within the Surgery for Trichiasis, Antibiotics to Prevent Recurrence (STAR) clinical trial conducted in Ethiopia. Demographic information, ocular examinations, and physical functioning assessments were collected before and 6 months after surgery. A single score for patients' physical functioning was constructed using Rasch analysis. A multivariate linear regression model was used to determine if change in physical functioning was associated with change in visual acuity.
  
  
  RESULTS
  Of the 438 participants, 411 (93.8%) had both baseline and follow-up questionnaires. Physical functioning scores at baseline ranged from -6.32 (great difficulty) to +6.01 (no difficulty). The percentage of participants reporting no difficulty in physical functioning increased by 32.6%; the proportion of participants in the mild/no visual impairment category increased by 8.6%. A multivariate linear regression model showed that for every line of vision gained, physical functioning improves significantly (0.09 units; 95% CI: 0.02-0.16).
  
  
  CONCLUSIONS
  Surgery to correct trichiasis appears to improve patients' physical functioning as measured at 6 months. More effort in promoting trichiasis surgery is essential, not only to prevent corneal blindness, but also to enable improved functioning in daily life.
authors.affiliation: Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD 21287, USA.
authors.forename: Meraf A
authors.initials: MA
authors.lastname: Wolle
authors.forename: Sandra D
authors.initials: SD
authors.lastname: Cassard
authors.forename: Emily W
authors.initials: EW
authors.lastname: Gower
authors.forename: Beatriz E
authors.initials: BE
authors.lastname: Munoz
authors.forename: Jiangxia
authors.initials: J
authors.lastname: Wang
authors.forename: Wondu
authors.initials: W
authors.lastname: Alemayehu
authors.forename: Sheila K
authors.initials: SK
authors.lastname: West
mesh_terms: D000203:Activities of Daily Living; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D017963:Azithromycin / Q000008:administration & dosage; D016022:Case-Control Studies; D005002:Ethiopia / Q000453:epidemiology; D005143:Eyelids / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D055502:Secondary Prevention; D018434:Sickness Impact Profile; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D058457:Trichiasis / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin