Progress in surgical treatment of congenital entropion / 国际眼科杂志(Guoji Yanke Zazhi)

Congenital entropion, an abnormal condition in which the eyelids roll inward, with the eyelashes losing their normal angulation and tilting toward the eye, especially in the lower eyelids and inner canthus, often occurs in infants and young children. Congenital entropion may lead to corneal epithelial abrasion, inflammation and ulcer, which may affect the function of the eye if not treated in time. Early surgical intervention is helpful to the health of children's eyes. The purpose of surgery is to change the structure of eyelid and weaken the force of entropion, thus improving the symptoms and corneal astigmatism. At present, there are many surgical treatments for congenital entropion. In this paper, the advantages, disadvantages and indications of these treatments are analyzed and summarized, providing a reference for clinical practice.

A novel interlamellar oral mucosa graft surgery technique using fibrin glue for the treatment of trichiasis / Nova técnica cirúrgica de enxerto interlamelar de mucosa oral usando cola de fibrina para o tratamento de triquíase

ABSTRACT Purpose: The purpose of this study was to evaluate the long-term outcomes of patients with trichiasis treated with a modified interlamellar oral mucosa graft surgery technique using fibrin glue. Methods: A prospective study was conducted at the Oculoplastic Department of Ouro Verde Hospital Complex. Patients with recurrent trichiasis without entropion who did not respond to conventional therapy, underwent intermarginal lamellar splitting of the eyelid and oral mucous graft insertion with fibrin glue replacing sutures. They were then evaluated at 1-day, 1-week, 1-month, 6-month, and 4-year follow-ups. Graft adherence, symptom resolution, esthetic satisfaction, overall patient satisfaction, and trichiasis recurrence were assessed at 6-month and 4-year follow-ups. Results: Fifteen patients (a total of 19 eyes) were included, of whom 10 (66.7%) were female and 5 (33.3%) were male. The mean age was 75.4 ± 10.5 years (range, 54-98 years). Acquired trichiasis was the main cause. Of the patients with acquired trichiasis, 12 (86.7%) had chronic blepharitis, 2 (13.3%) had an undetermined cause, and one (6.7%) had trachomatous trichiasis. Most cases involved only one eyelid segment (89.4%) and =5 lashes (84.2%; minor trichiasis). No adverse reactions from the fibrin glue were reported and no sutures were required after graft placement. At 6 months, no graft failures occurred, 17 eyes of 13 patients (89.4%) showed good graft adherence, 2 eyes of 2 patients (10.5%) showed partial graft adherence, and 2 eyes of 1 patient (10.5%) had trichiasis recurrence. At 4-year follow-up, no graft failure occurred, 3 patients (3 eyes) were lost to follow-up, and 2 eyes of 2 patients (14.2%) had trichiasis recurrence. The 4-year cumulative success rate was 78.9%. Conclusions: The modified interlamellar surgery with fibrin glue showed a good long-term success rate. This technique reduces surgical time, facilitates smaller graft insertion, and therefore, should be considered for recalcitrant minor trichiasis without entropion.>

RESUMO Objetivo: O objetivo deste estudo foi avaliar os resultados a longo prazo da técnica cirúrgica modificada de enxerto interlamelar de mucosa oral usando cola de fibrina para o tratamento de triquíase. Métodos: Um estudo prospectivo foi realizado no Departamento de Óculo-plástica do Complexo Hospital Ouro Verde. Pacientes com triquíase recorrente sem entrópio, que não responderam à terapia convencional, foram submetidos à cirurgia com separação intermarginal das lamelas das pálpebras e inserção de enxerto de mucosa oral usando cola de fibrina, substituindo a sutura. Pacientes foram avaliados 1 dia, 7 dias, 1 mês, 6 meses e 4 anos após a cirurgia. A aderência do enxerto, resolução dos sintomas, satisfação estética, satisfação geral do paciente e recorrência de triquíase foram avaliados aos 6 meses e aos 4 anos. Resultados: Quinze pacientes (total de 19 olhos) foram incluídos, dos quais 10 (66.7%) eram do sexo feminino e 5 (33.3%) do sexo masculino. A média de idade foi 75.4 ± 10.5 anos (intervalo 54-98 anos). Triquíase adquirida foi a principal causa, da qual 12 pacientes apresentaram blefarite crônica (86.7%), 2 pacientes com causa indeterminada (13.3%) e 1 paciente com triquíase tracomatosa (6.7%). A maioria dos casos envolveu apenas um segmento da pálpebra (89.4%) e com =5 cílios (84.2%; triquíase menor). Nenhuma reação adversa foi reportada com o uso da cola de fibrina e nenhum caso necessitou de sutura após inserção do enxerto. Aos 6 meses, não houve nenhuma falha de enxerto, 17 olhos de 13 pacientes (89.4%) apresentaram boa aderência de enxerto, 2 olhos de 2 pacientes (10.5%) mostraram aderência parcial do enxerto e 2 olhos de 1 paciente (10.5%) apresentaram recorrência da triquíase. Aos 4 anos, não houve nenhuma falha de enxerto, 3 olhos de 3 pacientes tiveram perda de seguimento e 2 olhos de 2 pacientes (14.2%) apresentaram recorrência da triquíase. A taxa de sucesso acumulativa após 4 anos foi de 78.9%. Conclusão: A cirurgia modificada de enxerto interlamelar de mucosa oral usando cola de fibrina mostrou uma boa taxa de sucesso a longo prazo. Esta técnica reduz o tempo cirúrgico, facilita a inserção de enxertos menores e, portanto, deve ser considerada em triquíase menor sem entrópio resistente ao tratamento convencional.

Effect of surgical time on the development of visual refraction in children with congenital entropion and trichiasis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect of surgical time on the development of visual refraction in children with congenital entropion and trichiasis.<p>METHODS: This was a prospective interventional study. Fifty nine eyes of 30 patients aged from 2 to 12 years old who suffered congenital lower eyelid entropion with trichiasis were divided into three groups according to the age. Improvement in binocular vision, refractive error, retinography astigmatism and cornea astigmatism by topography were analyzed. All patients were followed up for a period of 6 to 12mo.<p>RESULTS: There were no significant complications of overcorrection, undercorrection or eyelid deformity. The postoperative corneal astigmatism(CC)was significantly improved in three groups(<i>P</i><0.05). retinography astigmatism(RC)and best corrected visual acuity(BCVA)were significantly improved in low-aged and middle-aged groups(<i>P</i><0.05). The proportion of astigmatism with the rule and amblyopia was larger in middle-aged group. The postoperative CC, RC and BCVA was not statistically different in high-aged group(<i>P</i>>0.05).<p>CONCLUSIONS: Children with congenital entropion and trichiasis should be corrected surgically before 6 years old. The incidence of astigmatism with the rule and amblyopia is higher in 4 to 6 aged children and should be corrected earlier.

Correction of Diffuse Trichiasis Using Eyelid Margin Splitting Combined with Cilia Rotation Suture

PURPOSE: In the present study, we introduced and evaluated the effectiveness of eyelid margin splitting combined with cilia rotation suture performed in simplified steps resulting in minimized complications in diffuse trichiasis. METHODS: A retrospective review of medical records was performed on 31 eyelids of 21 patients with diffuse trichiasis. The patients had trichiasis of more than 1/3 of eyelid margin and received eyelid margin splitting combined with cilia rotation suture at our hospital. The patients did not have eyelid or lid margin abnormalities and were followed up more than 6 months after surgical correction. A telephone survey of the surgical outcomes including cosmetic satisfaction and recurrence was conducted in patients who did not visit at postoperative 12 months. Success was defined as complete resolution of symptoms and acceptable cosmesis at final visit. RESULTS: The patients included 2 males (3 eyes) and 19 females (28 eyes) with an average age of 54.5 ± 18.3 years (range, 19.2–82.4 years). The mean follow-up period was 15.3 ± 5.6 months (range, 10–35 months). Cornea or conjunctiva irritation symptoms by misdirected eyelash were resolved in all eyelids; 3 eyelids with recurred trichiasis required additional electrolysis to remove irritating cilia resulting in an overall success rate of 90.3%. CONCLUSIONS: For patients with diffuse trichiasis, an eyelid margin splitting combined with cilia rotation suture performed in simplified surgical steps showed excellent results resolving irritating symptoms with very low recurrence rate and high cosmetic satisfaction.

Prevalence of trachoma trichiasis and corneal opacity in the Shaanxi Province of China / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM: To assess the current situation of trachoma in Shaanxi Province and analyze its epidemiology and clinical features.?METHODS: The World Health Organization ( WHO ) simplified trachoma grading system was used for the recognition and registration of cases of trachoma. Trachoma rapid assessment ( TRA ) was conducted and 30.3687 million people from Shaanxi province were screened. Eyelids, eyelashes, conjunctiva and cornea were examined.The prevalence of trachoma trichiasis ( TT) in Shaanxi Province was estimated.?RESULTS: Totally 987 cases with TT were collected in Shaanxi province, in which 395 cases were male and 592 cases were female. The overall TT prevalence was 0.0325‰.The age of TT cases ranged from 25-86 years old, and concentrated in the 60-80 years old, only 58 cases were <50 years old.There were 12 cases of TT combined corneal opacity (CO) and the ratio was 1.2%. Sixty-four patients were cured by electrolysis trichiasis, the remaining 923 patients corrected by surgery interventions.?CONCLUSION: Based on the results of this study, trachoma blind is no longer estimated as a public health problem in Shaanxi province, as the detection rate of TT was less than 1‰ which is the goal of “elimination of trachoma” worldwide.

Blinding trachoma among refugees: Complicating social disaster

Objective: To determine the prevalence of blinding trachoma among refugees in South Western Ethiopia. Methods: A cross-sectional outreach clinic based descriptive study was conducted on 1 054 refugees in Southwest Ethiopia. A basic eyelid and cornea examination for signs of trachoma was done by using 2.5× binocular magnifying loupe. The findings were classified by using the World Health Orgnization simplified trachoma grading system and data were analyzed by using SPSS version 16.0. Results: A total of 1 054 refugee patients were examined for trachoma, 179 (16.98%) of them had clinical signs of trachoma. About 6 (3.35%) patients had active trachoma with trachomatous trichiasis (TT), 47 (26.26%) patients had TT only and the rest 126 (70.39%) patients had TT with trachomatous corneal opacity. All of the trachoma patients had blinding trachoma (TT with or without trachomatous corneal opacity), and about 60.89% of them had visual impairment. Blinding trachoma was significantly more common among females, patients in age group of 16-59 years, married patients, illiterates and Fugnido camp settlers (P<0.05). Conclusions: There is a very high burden of blinding trachoma among refugees. Urgent surgical intervention is needed to prevent blindness and low vision in the study subjects, and targeted regular outreach-based eye care service should be commenced.

Lid Splitting with Lash Resection for Trichiasis in Long-Standing Leprosy / 나학회지

BACKGROUND: Trichiasis is the inward inversion of the eyelash, resulting in painful contact with the cornea, which is a common symptom of patients with leprosy seeking treatment in leprosy outpatient clinics. Recurrence rates are high when trichiasis is treated with conventional methods such as epilation and electrolysis. OBJECTIVE: To evaluate prospectively a more aggressive surgical technique, lid splitting with lash resection, for trichiasis in long standing leprosy as a pilot study. METHODS: During the past 10 months, we treated 12 leprosy patients (18 eyelids) for trichiasis by splitting the lid margin at the gray line with resection of the eyelash bearing portion to modify the anterior lamellar repositioning. RESULTS: In all patients, pain disappeared immediately and there were no complications. The low number of patients and relatively short follow-up period are study limitations. CONCLUSION: The lid splitting with lash resection for trichiasis in patients with long standing leprosy is a satisfied treatment method functionally and cosmetically.

The Epidemiology of Trachoma in the Lower Shire Valley of Southern Malawi and Implications for the “SAFE” Strategy.

Aims: To determine the prevalence of trachoma and associated risk factors in the Lower Shire Valley of Southern Malawi. Study Design: Population based cross sectional study. Place and Duration of Study: Lower Shire Valley of southern Malawi between July and October 2012. Methodology: Children aged 1-9 years (total 2957) were assessed for clinical signs of active trachoma follicular (TF) and adults aged 15 and above (total 2247) were assessed for signs of trachoma trichiasis (TT), which is potentially blinding trachoma. A questionnaire survey was conducted to explore the potential risk factors. Results: A total of 2957 children aged 1-9 years who were assessed for clinical signs of TF and 2247 adults aged 15 and above were assessed for signs of TT.The prevalence of TF among children aged 1-9 years was found to be 18.5% (95% CI 16.4-20.8) in Nsanje and 7.8% (95% CI 6.6-9.2) in Mwanza districts respectively. The prevalence of TT in adults aged 15 and above was 0.5% (95% CI: 0.1-0.9) in Nsanje district and 0.2% (95% CI: 0.1-0.4) in Mwanza district, respectively. In regards to risk factors, only the presence of a dirty face was associated with trachoma follicular (TF) in Nsanje and Mwanza districts (P< 0.001). Conclusion: In this study, prevalence of active trachoma infections was 18.5% in Nsanje and 7.8% in Mwanza district. Dirty face was associated with trachoma follicular in both districts. According to WHO, Nsanje therefore needs a SAFE (Surgery, Antibiotics, Face Washing and Environmental) control strategy.

Ectopia cilia with pedigree analysis: Second case report in the world.

We present a case of ectopia cilia in a 28‑year‑old male patient. Ectopia cilia was were seen in the outer third of left upper eyelid. The patient’s maternal grandfather also had ectopia cilia of the left upper eyelid as reported by the patient’s mother. Ectopia cilia is a rare condition seen in humans. Only 12 cases of ectopic cilia in humans have been reported so far in the world. The present case of ectopia cilia is the second case report in the world with pedigree analysis.

The Effect of 0.02% Mitomycin C Injection into the Hair Follicle with Radiofrequency Ablation in Trichiasis Patients

PURPOSE: To investigate the inhibitory effect of 0.02% mitomycin C on eyelash regrowth when injected to the eyelash hair follicle immediately after radiofrequency ablation. METHODS: We prospectively included 21 trichiasis patients from June 2011 to October 2012. Twenty eyes of 14 patients were treated with 0.02% mitomycin C to the hair follicle immediately after radiofrequency ablation in group 1, while radiofrequency ablation only was conducted in ten eyes of seven patients in group 2. Recurrences and complications were evaluated until six months after treatment. RESULTS: One hundred sixteen eyelashes of 20 eyes in group 1 underwent treatment, and 19 (16.4%) eyelashes recurred. Eighty-four eyelashes of ten eyes in group 2 underwent treatment, and 51 (60.7%) eyelashes recurred. No patients developed any complications related to mitomycin C. CONCLUSIONS: Application of 0.02% mitomycin C in conjunction with radiofrequency ablation may help to improve the success rate of radiofrequency ablation treatment in trichiasis patients.

The Effect of 0.02% Mitomycin C Injection into the Hair Follicle with Radiofrequency Ablation in Trichiasis Patients

PURPOSE: To investigate the inhibitory effect of 0.02% mitomycin C on eyelash regrowth when injected to the eyelash hair follicle immediately after radiofrequency ablation. METHODS: We prospectively included 21 trichiasis patients from June 2011 to October 2012. Twenty eyes of 14 patients were treated with 0.02% mitomycin C to the hair follicle immediately after radiofrequency ablation in group 1, while radiofrequency ablation only was conducted in ten eyes of seven patients in group 2. Recurrences and complications were evaluated until six months after treatment. RESULTS: One hundred sixteen eyelashes of 20 eyes in group 1 underwent treatment, and 19 (16.4%) eyelashes recurred. Eighty-four eyelashes of ten eyes in group 2 underwent treatment, and 51 (60.7%) eyelashes recurred. No patients developed any complications related to mitomycin C. CONCLUSIONS: Application of 0.02% mitomycin C in conjunction with radiofrequency ablation may help to improve the success rate of radiofrequency ablation treatment in trichiasis patients.

Comparison of two surgical treatments for pediatric lower eyelid trichiasis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the clinical results of suture method and partial eyelash resection treating for pediatric eyelid trichiasis, and screen an effective method for the treatment of pediatric lower eyelid trichiasis. METHODS: Fifty-six cases of pediatric patients with lower eyelid trichiasis were randomly divided into a control group and an observation group in accordance with the method of drawing lots, and each group was 28 cases. The control group was treated with suture method, and the observation group was treated with partial eyelash resection. The clinical efficacy, patient satisfaction before and after treatment, and the incidence of complications were compared. RESULTS:(1) The clinically total effective rate was 74%of the control group, which was 89% of the observation group, and there were statistical differences of the clinical efficacy between the two groups ( P CONCLUSION: The treatment of children with lower eyelid trichiasis, suture method is simple and can be performed under local anesthesia in collaboration with children, but with a higher relapse rate, some patients required reoperation;partial resection of eyelashes can be more thoroughly solve the problem of pediatric eyelid trichiasis with low recurrence rate, but children need to be under general anesthesia with some of big risk. So partial resection of eyelashes is unsuitable for using in clinical practice widely and can be used in special cases.

Clinical and Microbiological Assessment of Trachoma in the Kolofata Health District, Far North Region, Cameroon

Background and aims: Trachoma is a sight-threatening process triggered by the infection of the conjunctiva with <i>Chlamydiae</i>. Blindness associated with trachoma was reported in Sahelian areas of Cameroon. However, data on the prevalence of this neglected infection in the Far North Region are not available. The aim of this study was a) to assess clinical trachoma and b) to detect <i>Chlamydia</i> in the conjunctiva of trachomatous populations living in the Far North Regions of Cameroon.Methods: A total of 2,423 randomly selected children (1–10 years) and 1,590 women over 14 from randomly selected villages from the Kolofata Health District (115,000 inhabitants) were included in a cross-sectional study in February 2009. Trained staff examined and obtained conjunctival swabs from trachomatous subjects. DNA was extracted and amplified to detect <i>Chlamydia</i> DNA by real-time PCR. The quality of sampling was assessed by quantifying the number of epithelial cells.Results: Children (2,397 or 98.9% of the predicted number) and women (1,543; 97.0%) were examined. The prevalence of follicular trachoma (TF) in children was 21% (95% CI 17.8–24.5) and of intense inflammatory trachoma (TI) 5.2% (95% CI 3.6–7.3). Among the women, trichiasis (TT) was observed in 3.4% (95% CI 2.4–4.7), corneal opacities (CO) in 1.4% (95% CI 0.8–2.3) and trachoma-related blindness in 0.9% (95% CI 0.4–1.8). Conditions related to income, illiteracy, latrines, water supply and animals wandering close to dwellings were similar in all the villages. PCR was positive in 35% of children with active trachoma and in 6% of adult females presenting TT and/or related corneal opacities.Conclusion: The prevalence of trachoma and the severe trachoma <i>sequelae</i> found during this survey underline the urgent need to implement efficient blindness prevention interventions to improve the visual future of the people in the Sahelian region.

Effects of Mitomycin C on Eyelash-Regrowth in Epilated Rats

PURPOSE: The aim of the present study was to determine the effects of mitomycin C (MMC) on eyelash regrowth in rats. METHODS: Ten rats were subjected to bilateral eyelid epilation. One drop of 0.04% MMC solution and one drop of normal saline was then administered to the right and left eyelid, respectively. Three months post-epliation, the number of regrown eyelashes was counted, and a section of tissue from each eyelid was examined under light- and electron microscopies. RESULTS: The number of regrown long eyelashes was 1.0 +/- 0.81 on the right, and 12.5 +/- 1.08 on the left. The rate of regrowth was 7.35 +/- 5.55% on the right and 98.45 +/- 3.27% on the left. Histological examination revealed no significant differences between the right and left eyelids, except for the absence of any hair shafts in the follicles on the right. However, electron microscopy revealed mitochondrial damage in the follicles of the right eyelid. These changes were not observed in tissue from the left eyelid. CONCLUSIONS: The application of 0.04% MMC inhibited the regrowth of normal eyelashes in rats following simple epilation. These results suggest that MMC may be a novel therapy for replacing invasive surgery in trichiasis with no malpositioning.

Clinical effects of intra-lamellar orbicularis dissecting micro-traumatic double eyelid surgery for the treatment of adolescent upper eyelid trichiasis / 中华医学美学美容杂志

Objective To evaluate the clinical effects of intra-lamellar orbicularis dissecting micro-traumatic double eyelid surgery for the treatment of adolescent upper eyelid trichiasis. Methods Three cutaneous micro-incisions following intra- and sub-lamellar orbicularis dissections were performed and the deep orbieularis and suborbicularis fat pad between the intended eyelid crease and 1 mm above the eyelid margin were resected. The subcutaneous orbicularis was fixed to the exposed levator aponeurosis at the medial, center and lateral regions. For the quantitative analysis, the entire eyelid margins' eyelashes were equally divided into three sections and the eyelashes lift-up angle (LA), the body curl-up angle (BC) and the end curl-up angle (EC) were compared before and after surgery in each section, respectively. Results One hundred and fourteen eyes of 57 cases were followed up during 24-30 months. Compared to the LA before surgery and 2 years after surgery, it was changed from (26.37±9.67)° to (55.42± 10.03)° in section Ⅰ , and from (22.03±11.64)° to (50.03±10.02)° in section Ⅱ , and from (25.31±8.01)° to (64.05±8.33)° in section Ⅲ. There were no significant changes of BC and EC during following-up. Con-clusions For the adolescent upper eyelid trichiasis, the intra-lamellar orbicularis dissecting micro-trau-matic double eyelid surgery could acquire satisfactory aesthetic appearance and stable eyelashes'position at the same time.

Treatment of Distichiasis or Trichiasis combined with Entropion

PURPOSE: To evaluate the clinical efficacy of a reverse eyelid splitting technique that we performed in cases of trichiasis or distichiasis combined with entropion. METHODS: The study comprised 43 eyes of 31 patients with trichiasis or distichiasis combined with entropion treated from November 2004 to December 2005. After skin incision, the muscular layer and tarsus were reversely dissected to find abnormal follicles. The abnormal hair follicle was cauterized under the muscular layer, and 2~3 rotating sutures were done with Ethilon 6-0 to fix the tarsus and skin. Success was defined as having the meibomian gland located in front of the junction of skin and mucosa, without an abnormal hair protruding into the eye for at least three months. RESULTS: Fifteen patients were male and sixteen patients were female. The mean age was 62.1+/-15.2 years. The patients were followed up for an average of 12.4+/-2.0 months after surgery. Surgery was successful in 74.4% (32 of the 43 eyelids) of the cases, and the recurrence rate was 25.6% (11 of the 43 eyelids). No severe complications occurred, such as infection, hemorrhage, wound dehiscence, or granuloma. However, foreign body sensation (1 eye) and eyelid notch (l eye) did occur. CONCLUSIONS: This reverse eyelid splitting technique produced satisfactory results in both cosmetic and functional aspects. Moreover, it resulted in a low recurrence rate and low complication rate in patients with trichiasis or distichiasis combined with entropion.

A Report of Localized Corneal Amyloidosis Secondary to the Trichiasis

PURPOSE: To report our experience in the diagnosis and treatment of a localized corneal amyloidosis secondary to trichiasis. METHODS: Case 1. A 55-year-old woman visited our clinic due to discomfort of her right eye. Thirty years previously, she received a lower lid blepharoplasty due to lower lid entropion. Biomicroscopy revealed some trichiasis and a 3 mm, grayish-white nodule at the center of the cornea. Case 2. A 30-year-old woman visited our clinic due to chronic irritation of both eyes. Ten and 3 years previously, she received a lower lid blepharoplasty. Biomicroscopy revealed some trichiasis of the right lower lid and a grayish-white, patch-like lesion at the inferior cornea of both eyes. Lamellar keratectomy and amniotic membrane transplantation with careful electrolysis were performed. RESULTS: Hematoxylin and eosin stain revealed a pink, amorphous, hyaline material under the epithelium, and Congo-red stain showed birefringence of the whitish lesion. Electron microscopy revealed multidirectional, fibrillar arrangement. Secondary, localized amyloidosis of the cornea was diagnosed without any systemic involvement. No clues to the origin of the amyloid were found by immunohistochemical staining. By the sixth month after operation, the patients showed favorable vision and no evidence of recurrence. CONCLUSIONS: In the identification of a corneal mass, a secondary, localized amyloidosis should be considered, which can be managed successfully.

A Case of Salzmann's Nodular Degeneration Caused by Chronic Irritation of Dry Eye and Trichiasis

PURPOSE: To report a case of Salzmann's nodular degeneration caused by chronic irritation from dry eye and trichiasis. METHODS: A 40-year-old female patient visited our ophthalmology clinic complaining of dryness in both eyes. History taking, measurement of visual acuity and intraocular pressure, and slit-lamp examination were performed. RESULTS: We found greyish white nodular opacities which protruded from the inferior corneal surface, and trichiasis at the lower eyelids. Epilation was performed, artificial tear, and lubricating ointment were prescribed, and therapeutic lens was applied. After 3 months of treatment, the symptom was relieved and nodular opacities diminished. CONCLUSIONS: Phlyctenular keratitis, vernal keratoconjunctivitis, trachoma, scarlet fever, postoperative corneal surgery, hard contact lenses, and keratoconus are well known for the course of Salzmann's nodular degeneration. The chronic irritation from dry eye and trichiasis could be the cause of Salzmann's nodular degeneration.

A Clinical Effects between Ellman Surgitron(R) Thermolysis and Argon Laser Thermoablation in Trichiasis

PURPOSE: To determine the therapeutic effect between Ellman Surgitron(R) thermolysis and Argon laser thermoablation in patients with trichiais. METHODS: Thirty-one patients (46 eyes) were analyzed. We performed Argon laser thermoablation in 23 patients (35 eyes) and Ellman Surgitron(R) thermolysis in 8 patients (11 eyes). Mean age was 54. Mean follow-up period was 11 months in Ellman Surgitron(R) group, 46 months in Argon laser group. RESULTS: In Argon laser group, 17 cases of 13 patients were performed successfully in first procedure (48.6%), and cumulative success rate was 68.6% after second procedure. Eleven eyes of 6 patients (31.4%) were performed more than three times or needed to surgical intervention. On the other hand, in Ellman Surgitron(R) group, 7 cases of 5 patients (63.6%) were successfully performed in first procedure, and second procedure makes all patients allowed to be successful in treatment of trichiasis. In all two groups, complications such as lid defect, granulation tissue formation, continuous pain and erythematous skin lesions were not found. CONCLUSIONS: The success rate of Ellman Surgitron(R) thermolysis is higher than Argon laser thermoablation, and all patients in Ellman Surgitron(R) group were treated within second procedure without recurrence. The above results suggest that Ellman Surgitron(R) thermolysis is one of the good methods to treat trichiasis.

Treatment of Trichiasis and Districhiasis with Ellman Dento-Surg 90FFP

PURPOSE: To evaluate the efficacy of the Ellman Dento-Surg 90FFP for the isolated trichiasis or distichiasis. METHODS: 61 eyelashes of 23 patients, who were diagnosed as trichiasis or distichiasis and had less than 5 aberrant cilia that were isolated, were treated with the Ellman Dento-Surg 90FFP. At 1 week, 1 month, 2 month and 6 month postoperatively, we examined the success rate and postoperative complication. RESULTS: Fifteen eyelashes of 9 patients were regrown after mean 1.3month follow-up period (75.4% success rate). Among 10 eyelashes of 6 patients, 2 eyelashes of 2 patients were regrown (80% success rate). Thirteen patients experienced mild burning sensation 1-2 days postoperatively. Eyelid notching was observed in 2 patients. CONCLUSIONS: High frequency radio wave electrosurgery with Ellman Dento-Surg 90FFP is a simple and secure procedure with high success rate and negligible complication, and can be effectively used to treat isolated trichiasis or distichiasis.