title: The trachomatous trichiasis clamp: a surgical instrument designed to improve bilamellar tarsal rotation procedure outcomes.
abstract: The World Health Organization has endorsed the bilamellar tarsal rotation procedure to correct blinding trachomatous trichiasis. Our field observations of bilamellar tarsal rotation have revealed some significant departures from this procedure as described in the World Health Organization manual. We designed the trachomatous trichiasis clamp to address the shortcomings of the standard instrumentation and to help nonphysicians perform the procedure more safely, reproducibly, and successfully. The trachomatous trichiasis clamp standardizes several aspects of the surgical technique that are not always performed consistently, providing guides for correct clamp and incision placement. A full-thickness eyelid incision can be made and sutures placed in a bloodless field. Two surgical technicians tested the trachomatous trichiasis clamp in 10 patients and found that it was easier to use, shortened surgery time, allowed straighter and more precisely placed incisions, and offered excellent protection for the eye.
authors.affiliation: Department of Ophthalmology, Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Shannath L
authors.initials: SL
authors.lastname: Merbs
authors.forename: Amir B
authors.initials: AB
authors.lastname: Kello
authors.forename: Hassan
authors.initials: H
authors.lastname: Gelema
authors.forename: Sheila K
authors.initials: SK
authors.lastname: West
authors.forename: Emily W
authors.initials: EW
authors.lastname: Gower
mesh_terms: D019882:Blepharoplasty / Q000295:instrumentation*; D004867:Equipment Design; D005143:Eyelids / Q000601:surgery*; D006801:Humans; D011785:Quality Assurance, Health Care; D014141:Trachoma / Q000382:microbiology / Q000601:surgery*; D016896:Treatment Outcome; D058457:Trichiasis / Q000382:microbiology / Q000601:surgery*