Woreta Fasika, Munoz Beatriz, Gower Emily, Alemayehu Wondu, West Sheila K
Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, 600 N Wolfe St, Baltimore, MD 21287, USA.
Arch Ophthalmol. 2012 Apr;130(4):427-31. doi: 10.1001/archophthalmol.2011.374. Epub 2011 Dec 12.
To determine whether treatment with oral azithromycin compared with topical tetracycline reduces the recurrence of trichiasis for up to 3 years following surgery for trichiasis.
The Surgery for Trichiasis, Antibiotics to Prevent Recurrence (STAR) trial is a randomized, single-masked, clinical trial conducted in southern Ethiopia, a region where trachoma is hyperendemic. A total of 1452 patients who underwent trichiasis surgery were randomly assigned at a 2:1 ratio to either a single dose of oral azithromycin (1 g) or topical tetracycline (twice per day for 6 weeks) following surgery.
Recurrence of trichiasis within 3 years following surgery.
The rate of recurrence was 10% in the azithromycin group and 13% in the tetracycline group. The azithromycin group had a 22% reduction in recurrence of trichiasis 3 years after surgery compared with the tetracycline group (P = .13). Severity of entropion at baseline was the most significant predictor of recurrence of trichiasis at 3 years.
Trichiasis recurrence rates in the STAR trial remained low for up to 3 years following surgery. The protective effect of a single dose of azithromycin was less than at 1 year and, although not statistically significant, was still suggestive up to 3 years following trichiasis surgery.
A single dose of azithromycin after surgery remains an integral component of the World Health Organization's strategy for the elimination of trachoma by the year 2020.
确定与局部应用四环素相比，口服阿奇霉素治疗能否降低倒睫手术后长达3年的复发率。
倒睫手术、抗生素预防复发（STAR）试验是在埃塞俄比亚南部进行的一项随机、单盲临床试验，该地区沙眼高度流行。共有1452例行倒睫手术的患者术后按2:1的比例随机分配接受单剂量口服阿奇霉素（1克）或局部应用四环素（每天两次，持续6周）。
手术后3年内倒睫的复发情况。
阿奇霉素组的复发率为10%，四环素组为13%。与四环素组相比，阿奇霉素组术后3年倒睫复发率降低了22%（P = 0.13）。基线时睑内翻的严重程度是3年时倒睫复发的最显著预测因素。
在STAR试验中，倒睫手术后长达3年的复发率仍然较低。单剂量阿奇霉素的保护作用虽不及术后1年时明显，尽管无统计学意义，但在倒睫手术后长达3年时仍有提示作用。
手术后单剂量阿奇霉素仍然是世界卫生组织到2020年消除沙眼战略的一个重要组成部分。
