Trichiasis Recurrence in North Ethiopia: a one Year Prospective Study of Trachomatous Trichiasis Surgery done by Integrated Eye Care Workers

ABSTRACT

Background: Blindness due to trachomatous trichiasis can be prevented by simple eyelid surgery that can be performed by trained nurses. Objective: To evaluate the post- operative outcome of posterior tarsal rotation done by integrated eye care workers (IECWs) at the twelfth postoperative month. Methods: A prospective study to evaluate trichiasis surgery for recurrence was conducted in Yilmana Densa District. Trained IECWs did transverse tarsotomy with lid margin rotation for 455 patients with trichiasis following the standard procedure. Post-operative follow-up evaluation was done at the 12th month by IECWs who neither took part in the operation nor knew the specific surgeons for the corresponding patients. Results: Out of 695 a total of 560 operated eyelids were available for follow-up just at the 12th month. In terms of persons; 79.3(361/455) patients came for follow-up evaluation. The recurrence rate among the operated eyelids was found to be 16.6. There was an increase in likelihood of having recurrence with increasing age of patients (X2=5.6; P=0.02). We also found a statistically significant difference in rates of recurrence among patients operated by different surgeons(X2 =12.8; P=0.005). Conclusion: Trichiasis recurrence following surgery done by non-ophthalmologists is low indica- ting the possibility of avoiding preventable blindness due to trachoma through the training of integrated eye care workers. Moreover; monitoring mechanism appeared essential to track the performance of IECWs