Anterior Lamellar Recession versus Posterior Lamellar Tarsal Rotation for Lower Lid Trachomatous Trichiasis: A Randomized Controlled Trial

Fatma M Abdelaziz, Mahmoud Ahmed Kamal, Mohamed M Said, Mostafa M Diab Department of Ophthalmology, Faculty of Medicine, Fayoum University, Al Fayoum, EgyptCorrespondence: Mostafa M DiabDepartment of Ophthalmology, Faculty of Medicine, Fayoum University, 12 George Nirose St, Al Mesalla, Fayoum, Al F...

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Autores principales: Abdelaziz FM, Kamal MA, Said MM, Diab MM
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Publicado: Dove Medical Press 2020
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spelling oai:doaj.org-article:838f04455a8d482d927b6d529f9758af2021-12-02T10:06:00ZAnterior Lamellar Recession versus Posterior Lamellar Tarsal Rotation for Lower Lid Trachomatous Trichiasis: A Randomized Controlled Trial1177-5483https://doaj.org/article/838f04455a8d482d927b6d529f9758af2020-07-01T00:00:00Zhttps://www.dovepress.com/anterior-lamellar-recession-versus-posterior-lamellar-tarsal-rotation--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Fatma M Abdelaziz, Mahmoud Ahmed Kamal, Mohamed M Said, Mostafa M Diab Department of Ophthalmology, Faculty of Medicine, Fayoum University, Al Fayoum, EgyptCorrespondence: Mostafa M DiabDepartment of Ophthalmology, Faculty of Medicine, Fayoum University, 12 George Nirose St, Al Mesalla, Fayoum, Al Fayoum 63514, EgyptTel +20 842152290Email Mmd11@fayoum.edu.egPurpose: To compare the outcomes of anterior lamellar recession (ALR) versus posterior lamellar tarsal rotation (PLTR) procedure for the repair of lower eyelid trachomatous trichiasis (TT).Design: Prospective randomized comparative trial.Methods: Study Population and Interventions: Patients with lower eyelid TT were enrolled. Patients with a history of lower lid surgery, marked horizontal lid laxity, another evident cause for the trichiasis, and those under 18 years were excluded. Participants were randomized to either PLTR or ALR. The sequence was computer-generated by an independent statistician, and the allocation sequence was concealed in sealed opaque envelops. Patients were evaluated at 1 week and 1, 3, 6, and 12 months. Main Outcome Measures: postoperative trachomatous trichiasis (PTT) and cosmetic satisfaction.Results: A total of 60 patients were randomly assigned with 30 patients in each group. Two (3.3%) participants in PLTR group did not follow up and were excluded from the analysis. At 1, 3, and 6 months, PTT was significantly more frequent in the PLTR group than the ALR group (14.3% vs 0%; p= 0.048, 25% vs 0%; p= 0.004, 35.7% vs 10%; p= 0.019, respectively). In the ALR group, 6 patients (20%) had PTT at their 12-month follow-up visit compared with 15 patients (53.6%) in the PLTR group (P = 0.008) with absolute risk reduction of 33.6% (95% (CI= 9% − 58%)). Cosmetic dissatisfaction was significantly more frequent in the ALR group at the initial follow-up visits compared to the PLTR group. However, this difference was no longer significant at 6 and 12 months follow-up.Conclusion: These data provide strong evidence that ALR is more effective in correction of lower eyelid trachomatous trichiasis with acceptable cosmesis compared with PLTR.Keywords: lower lid, trichiasis, anterior lamellar recession, posterior lamellar tarsal rotationAbdelaziz FMKamal MASaid MMDiab MMDove Medical Pressarticlelower lidtrichiasisanterior lamellar recessionposterior lamellar tarsal rotationOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 2043-2050 (2020)
institution DOAJ
collection DOAJ
language EN
topic lower lid
trichiasis
anterior lamellar recession
posterior lamellar tarsal rotation
Ophthalmology
RE1-994
spellingShingle lower lid
trichiasis
anterior lamellar recession
posterior lamellar tarsal rotation
Ophthalmology
RE1-994
Abdelaziz FM
Kamal MA
Said MM
Diab MM
Anterior Lamellar Recession versus Posterior Lamellar Tarsal Rotation for Lower Lid Trachomatous Trichiasis: A Randomized Controlled Trial
description Fatma M Abdelaziz, Mahmoud Ahmed Kamal, Mohamed M Said, Mostafa M Diab Department of Ophthalmology, Faculty of Medicine, Fayoum University, Al Fayoum, EgyptCorrespondence: Mostafa M DiabDepartment of Ophthalmology, Faculty of Medicine, Fayoum University, 12 George Nirose St, Al Mesalla, Fayoum, Al Fayoum 63514, EgyptTel +20 842152290Email Mmd11@fayoum.edu.egPurpose: To compare the outcomes of anterior lamellar recession (ALR) versus posterior lamellar tarsal rotation (PLTR) procedure for the repair of lower eyelid trachomatous trichiasis (TT).Design: Prospective randomized comparative trial.Methods: Study Population and Interventions: Patients with lower eyelid TT were enrolled. Patients with a history of lower lid surgery, marked horizontal lid laxity, another evident cause for the trichiasis, and those under 18 years were excluded. Participants were randomized to either PLTR or ALR. The sequence was computer-generated by an independent statistician, and the allocation sequence was concealed in sealed opaque envelops. Patients were evaluated at 1 week and 1, 3, 6, and 12 months. Main Outcome Measures: postoperative trachomatous trichiasis (PTT) and cosmetic satisfaction.Results: A total of 60 patients were randomly assigned with 30 patients in each group. Two (3.3%) participants in PLTR group did not follow up and were excluded from the analysis. At 1, 3, and 6 months, PTT was significantly more frequent in the PLTR group than the ALR group (14.3% vs 0%; p= 0.048, 25% vs 0%; p= 0.004, 35.7% vs 10%; p= 0.019, respectively). In the ALR group, 6 patients (20%) had PTT at their 12-month follow-up visit compared with 15 patients (53.6%) in the PLTR group (P = 0.008) with absolute risk reduction of 33.6% (95% (CI= 9% − 58%)). Cosmetic dissatisfaction was significantly more frequent in the ALR group at the initial follow-up visits compared to the PLTR group. However, this difference was no longer significant at 6 and 12 months follow-up.Conclusion: These data provide strong evidence that ALR is more effective in correction of lower eyelid trachomatous trichiasis with acceptable cosmesis compared with PLTR.Keywords: lower lid, trichiasis, anterior lamellar recession, posterior lamellar tarsal rotation
format article
author Abdelaziz FM
Kamal MA
Said MM
Diab MM
author_facet Abdelaziz FM
Kamal MA
Said MM
Diab MM
author_sort Abdelaziz FM
title Anterior Lamellar Recession versus Posterior Lamellar Tarsal Rotation for Lower Lid Trachomatous Trichiasis: A Randomized Controlled Trial
title_short Anterior Lamellar Recession versus Posterior Lamellar Tarsal Rotation for Lower Lid Trachomatous Trichiasis: A Randomized Controlled Trial
title_full Anterior Lamellar Recession versus Posterior Lamellar Tarsal Rotation for Lower Lid Trachomatous Trichiasis: A Randomized Controlled Trial
title_fullStr Anterior Lamellar Recession versus Posterior Lamellar Tarsal Rotation for Lower Lid Trachomatous Trichiasis: A Randomized Controlled Trial
title_full_unstemmed Anterior Lamellar Recession versus Posterior Lamellar Tarsal Rotation for Lower Lid Trachomatous Trichiasis: A Randomized Controlled Trial
title_sort anterior lamellar recession versus posterior lamellar tarsal rotation for lower lid trachomatous trichiasis: a randomized controlled trial
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/838f04455a8d482d927b6d529f9758af
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