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Lamellar Tarsectomy Procedure In Major Trichiasis Of The Upper Lid

Authors Elbaklish KH, Saleh SM, Gomaa WA

Received 26 March 2019

Accepted for publication 15 October 2019

Published 20 November 2019 Volume 2019:13 Pages 2251—2259


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Khaled Hamdi Elbaklish, Safaa M Saleh, Wael Adel Gomaa

Ophthalmology Department, Ain Shams University, Cairo, Egypt

Correspondence: Khaled Hamdi Elbaklish
Ophthalmology Department, Ain Shams University, Abbassia, Cairo 11566 Egypt
Tel +201000057550
Email khaled.hamdy62@yahoo.coffigm

Aims: Evaluation of failure rate and outcomes between skin and muscle surgery and lamellar tarsectomy procedure in major trichiasis of the upper lid.
Design: Quasi-randomized clinical study.
Methods and subjects: One hundred individuals with major trichiasis of the upper lid were enrolled and assigned to either skin and muscle surgery (group A) or a lamellar tarsectomy procedure (group B). Participants were examined at 6 and 12 months. The primary outcome measure (failure rate) was the percentage of participants having five or more eyelashes touching the globe or having surgery performed at any follow-up time in both groups. The secondary outcomes included failure time and changes in both visual acuity and corneal opacity.
Results: Risk failure over 6 months was 40% in group A and 10% in group B. Absolute risk reduction was 30% (95% CI=14.08–45.92%). Cumulative risk failure over 12 months was 20% in group A and 0.00% in group B after the second intervention. Absolute risk reduction was 20% (95% CI=8.58–31.42%). The number needed to treat (NNT) was 3.3 patients (95% CI=2.2–7.1). The mean number of rubbing lashes was greater in the skin and muscle group than in the lamellar tarsectomy group for 6 and 12 month examinations (0.002, 0.005). The change in visual acuity between the two groups was not significant. Recurrent trichiasis was noticed earlier, 6 weeks after surgery, in the skin and muscle group participants, and later, 3 months after surgery, in the lamellar tarsectomy group participants.
Conclusion: The lamellar tarsectomy procedure is a good choice for management of major trichiasis of the upper lid. The subjective symptoms and lid margin conjunctivalization were improved in lamellar tarsectomy participants. Absence of new corneal opacity or a change in existing corneal opacification was noticed at the 12 months follow-up study.

Keywords: tarsectomy, rubbing, lashes, trichiasis, lid

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