Treatment of trichiasis with high-frequency radiowave electrosurgery

ABSTRACT

Trichiasis, misdirected cilia rubbing against the globe, is a difficult therapeutic challenge despite the many treatments that have been tried. The goal of lash-ablating procedures is the destruction of all cells that have the ability to form new hair follicles. High frequency radiosurgery, the Ellman Surgitron IEC, produces hair follicle destruction with very few changes occurring less than 0.5 mm on either side of the targeted hair follicle. To assess the efficacy of high frequency radiowave electrosurgery as a method of trichiasis treatment. Seventy-one eyelids of 42 patients were treated by high frequency radiowave electrosurgery using the Ellman Surgitron IEC. The procedure was performed under local anesthesia as an outpatient treatment. Ellman radiofrequency settings in general were fulguration mode, 7 W output power, and duration varied between 5 to 7 seconds. The treatment was successful in 58 eyelids after a single treatment [81.7%], 65 eyelids following a second application [91.5%], and 69 eyelids that required retreatment twice [97%]. Two eyelids were scheduled for surgical correction of upper lid entropion. Complications were reported in 10 eyelids [14%] including notch, partial madarosis, progressive entropion, and hyperpigmentation with meibomian gland dysfunction. High frequency radiowave electrosurgery is an effective, rapid and easy-to-perform method of treatment of trichiasis with a high success rate due to controlled collateral tissue destruction