title: Absorbable versus silk sutures for surgical treatment of trachomatous trichiasis in Ethiopia: a randomised controlled trial.
abstract: BACKGROUND
  Trachoma causes blindness through an anatomical abnormality called trichiasis (lashes touching the eye). Trichiasis can recur after corrective surgery. We tested the hypothesis that using absorbable sutures instead of silk sutures might reduce the risk of recurrent disease among patients with major trichiasis in a randomised trial.
  
  
  RESULTS
  1,300 individuals with major trichiasis from rural villages in the Amhara Region of Ethiopia were recruited and assigned (1:1) by computer-generated randomisation sequence to receive trichiasis surgery using either an absorbable suture (polyglactin-910) or silk sutures (removed at 7-10 days) in an otherwise identical surgical technique. Participants were examined every 6 months for 2 years by clinicians masked to allocation. The primary outcome measure was recurrent trichiasis (≥one lash touching the eye) at 1 year. There was no difference in prevalence of recurrent trichiasis at 1 year (114 [18.2%] in the absorbable suture group versus 120 [19.7%] in the silk suture group; odds ratio = 0.90, 95% CI 0.68-1.20). The two groups also did not differ in terms of corneal opacification, visual acuity, conjunctival inflammation, and surgical complications.
  
  
  CONCLUSIONS
  There was no evidence that use of absorbable polyglactin-910 sutures was associated with a lower prevalence of trichiasis recurrence at 1 year postsurgery than silk sutures. However, from a programmatic perspective, polyglactin-910 offers the major advantage that patients do not have to be seen soon after surgery for suture removal. The postoperative review after surgery using absorbable polyglactin-910 sutures can be delayed for 3-6 months, which might allow us to better determine whether a patient needs additional surgery.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00522860.
authors.affiliation: The London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Saul N
authors.initials: SN
authors.lastname: Rajak
authors.forename: Esmael
authors.initials: E
authors.lastname: Habtamu
authors.forename: Helen A
authors.initials: HA
authors.lastname: Weiss
authors.forename: Amir Bedri
authors.initials: AB
authors.lastname: Kello
authors.forename: Teshome
authors.initials: T
authors.lastname: Gebre
authors.forename: Asrat
authors.initials: A
authors.lastname: Genet
authors.forename: Robin L
authors.initials: RL
authors.lastname: Bailey
authors.forename: David C W
authors.initials: DC
authors.lastname: Mabey
authors.forename: Peng T
authors.initials: PT
authors.lastname: Khaw
authors.forename: Clare E
authors.initials: CE
authors.lastname: Gilbert
authors.forename: Paul M
authors.initials: PM
authors.lastname: Emerson
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Burton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005002:Ethiopia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011098:Polyglactin 910 / Q000627:therapeutic use*; D012008:Recurrence; D047011:Silk / Q000627:therapeutic use; D013537:Sutures; D014141:Trachoma / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D058457:Trichiasis / Q000150:complications / Q000601:surgery*; D055815:Young Adult
chemical_list: D047011:Silk; D011098:Polyglactin 910