Pearson Katherine, Habte Dereje, Zerihun Mulat, King Jonathan D, Gebre Teshome, Emerson Paul M, Reacher Mark H, Ngondi Jeremiah M
Department of Public Health and Pharmacy Care, University of Cambridge, Cambridge, UK.
Ethiop J Health Sci. 2013 Jul;23(2):131-40.
Surgery to correct trachomatous trichiasis (TT) is recommended to prevent blindness caused by trachoma. This study evaluated the outcomes of community-based trichiasis surgery with absorbable sutures, conducted in Amhara Regional State, Ethiopia.
A simple random sample of 431 patients was selected from surgical campaign records of which 363 (84.2%) were traced and enrolled into the study. Participants were interviewed and examined for trichiasis recurrence, complications of TT surgery and corneal opacity. Multilevel logistic regression models were used to explore the associations between trichiasis recurrence, corneal opacity and explanatory variables at the eye level.
The prevalence of trichiasis recurrence was 9.4% (95% Confidence Interval [CI] 6.6-12.8) and corneal opacity was found in 14.3% (95% CI 10.9-18.3) of the study participants. The proportion of participants with complications of TT surgery was: granuloma 0.6% (95% CI 0.1-2.0); lid closure defects 5.5% (95% CI 3.4-8.4) and lid notching 16.8% (95% CI 13.1-21.1). No factors were identified for trichiasis recurrence. Corneal opacity was associated with increased age (Ptrend=0.001), more than 12 months post surgery (OR=2.7; 95%CI 1.3-5.6), trichiasis surgery complications (OR=2.9; 95%CI 1.4-5.9) and trichiasis recurrence (OR=2.5; 95%CI 1.0-6.3).
Prevalence of recurrent trichiasis and granuloma were lower than expected but higher for lid closure defects and lid notching. The majority of the participants reported satisfaction with the trichiasis surgery they had undergone. The findings suggest that recurrence of trichiasis impacts on the patients' risk of developing corneal opacity but longitudinal studies are required to confirm this.
建议通过手术矫正沙眼性倒睫（TT）以预防沙眼导致的失明。本研究评估了在埃塞俄比亚阿姆哈拉州开展的基于社区的可吸收缝线倒睫手术的效果。
从手术活动记录中选取431例患者的简单随机样本，其中363例（84.2%）被追踪并纳入研究。对参与者进行访谈，并检查倒睫复发情况、TT手术并发症及角膜混浊情况。采用多水平逻辑回归模型探讨倒睫复发、角膜混浊与眼部层面解释变量之间的关联。
倒睫复发率为9.4%（95%置信区间[CI] 6.6 - 12.8），14.3%（95%CI 10.9 - 18.3）的研究参与者存在角膜混浊。TT手术并发症的比例为：肉芽肿0.6%（95%CI 0.1 - 2.0）；眼睑闭合不全5.5%（95%CI 3.4 - 8.4）；眼睑切迹16.8%（95%CI 13.1 - 21.1）。未发现与倒睫复发相关的因素。角膜混浊与年龄增加（P趋势=0.001）、术后超过12个月（OR = 2.7；95%CI 1.3 - 5.6）、倒睫手术并发症（OR = 2.9；95%CI 1.4 - 5.9）及倒睫复发（OR = 2.5；95%CI 1.0 - 6.3）相关。
倒睫复发和肉芽肿的发生率低于预期，但眼睑闭合不全和眼睑切迹的发生率较高。大多数参与者对其所接受的倒睫手术表示满意。研究结果表明，倒睫复发会影响患者发生角膜混浊的风险，但需要纵向研究来证实这一点。
