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At least 1,063 records · Page 59Linked to original sources

Reconstruction of the eyelids of a dog using grafts of oral mucosa.

A five-month-old English cocker spaniel with distichiasis had been treated four times surgically by a tarsomeibomian resection technique. As a result, three-quarters of the margins of its upper eyelids had been eliminated and the lower eyelids had become considerably thinner. The dog had developed upper entropion and upper eyelid trichiasis, and keratoconjunctivitis sicca. It was treated medically and grafts of oral mucosa were used to reconstruct its upper eyelids. A year after surgery, the new palpebral margin was completely functional and cosmetically acceptable. The dog's eyes appear normal and only require treatment with artificial tears.

Animals↗

A contribution to the surgery of the trachomatous entropion and trichiasis.

Although the WHO document WHO/PBL/93.29 recommends the bilamellar tarsal rotation operation for trachomatous entropion, we will describe another operation that has proved to be very reliable. It is a combined method, consisting of the modified tarsal wedge resection and the eversion splinting-grey line incision. A possible additional correction of the grey line incision on the first postoperative day improves the results. A total of 708 eyes with moderate trachomatous entropion and major trichiasis underwent this surgery, but only 508 of these were followed up during a 6-month period. The rate of failed operations, which consisted of incomplete closure of the lids or more than two inverted lashes remaining, was 6.9%.

Entropion↗

Secondary localized amyloidosis of the cornea caused by trichiasis.

A 43-year-old woman complained of gradual visual impairment, foreign body sensation, and a white mass in the right eye. Trichiasis and corneal excrescence were observed. A systemic examination revealed no concurrent disease; the family history was noncontributory. A lamellar keratoplasty was performed. An amyloid deposit was found in the excised specimen histopathologically. Secondary localized amyloidosis of the cornea caused by trichiasis is a rare condition.

Adult↗

Use of argon laser photocoagulation in the treatment of recurrent trichiasis: long-term results.

We describe our technique and analyze the long-term results of the use of argon laser photocoagulation in the treatment of 92 eyes with recurrent trichiasis. In spite of an incidence of recurrences of 64.1% which had to undergo a new laser photocoagulation session, the final success rate of the method was impressive (91.3%). The number of misdirected cilia per lid seems to constitute an important factor which affects both the rate of recurrences and the success rate of the procedure.

Aged↗

Risk factors for postsurgical trichiasis recurrence in a trachoma-endemic area.

PURPOSE: The World Health Organization recommends trichiasis surgery to prevent blindness caused by trachoma; however, recurrence is common. Risk factors for recurrence have not been widely studied, particularly in trachoma hyperendemic areas. METHODS: Three hundred ninety-four persons with trichiasis in Tanzania were examined. Participants had undergone surgery >18 months before the study. Trichiasis recurrence and active trachoma at study visit were assessed. Ocular swabs were collected and tested for Chlamydia trachomatis. Household members were examined for active trachoma. RESULTS: Of the surgical eyes, 28% had recurrence; 40% of patients had recurrence in one or both eyes. Rates did not vary by time since surgery. Eye-level recurrence rates varied significantly across districts, ranging from 16% to 38%. Current chlamydial infection among surgical cases was low (6%) and was not associated with recurrence. Recurrence was associated with tarsal conjunctival inflammation (OR: 2.4; 95% confidence interval [CI]: 1.6-3.8) and residence in the Kongwa district (OR: 2.3; 95% CI: 1.2-4.6). CONCLUSIONS: Recurrence after trichiasis surgery is high, suggesting that vigilant follow-up in surgical cases is needed to reduce blindness. Recurrence is associated with evidence of inflammation in the tarsal conjunctiva, although it is not clear whether the inflammation contributes to recurrence, or is a result of the recurrence. Longitudinal studies of trichiasis patients after surgery are needed.

Aged↗

The long-term natural history of trachomatous trichiasis in the Gambia.

PURPOSE: Trachoma is the leading infectious cause of blindness. However, there are few data on the natural history of trachomatous trichiasis to guide program planning or that investigate its pathogenesis. METHODS: A cohort of Gambians with trichiasis in one or both eyes who had declined surgery was observed. Clinical examinations were performed at baseline and 4 years later. Conjunctival swab samples were collected for Chlamydia trachomatis PCR and bacteriology. RESULTS: One hundred fifty-four people were examined at baseline and 4 years later (241 nonsurgical eyes). At baseline 124 (52%) eyes had major trichiasis (5+ lashes), 75 (31%) minor trichiasis (1-4 lashes), and 42 (17%) no trichiasis. By 4 years, trichiasis had developed in 12 (29%) of 42 previously unaffected eyes. Minor trichiasis progressed to major in 28 (37%) of 75 eyes. New corneal opacification more commonly developed in eyes that had major (10%) compared to minor (5%) trichiasis at baseline. Bacterial infection was common (23%), becoming more frequent with increasing trichiasis. C. trachomatis infection was rare (1%). Conjunctival inflammation was common (29%) and was associated with progressive trichiasis and corneal opacification. CONCLUSIONS: Trichiasis progressed in the long-term in this environment, despite a low prevalence of C. trachomatis. Blinding corneal opacification develops infrequently, unless major trichiasis is present. Epilation and early surgery need to be formally compared for the management of minor trichiasis. The pathologic correlates and promoters of conjunctival inflammation need to be investigated.

Aged↗

Epiblepharon. An important and often missed diagnosis.

Epiblepharon is a common, often unrecognized cause of epiphora and ocular irritation in the child. Epiblepharon consists of an extra fold of eyelid skin and orbicularis muscle overlying an eyelid margin. Occasionally an epiblepharon can push the lashes against the sensitive corneas, especially in downgaze. This paper illustrates epiblepharon and stresses the need for eyelid margin examination in downgaze in the child with epiphora or conjunctivitis.

Child↗

Treatment of trichiasis with argon laser.

PURPOSE: In this prospective study, argon laser photocoagulation was used to eliminate misdirected cilia. The cases were followed up to see the results and recurrences with this treatment. METHODS: 60 eyelids of 45 patients with trichiasis were treated with the argon laser. After topical anesthesia a blue-green argon laser was used with 1 watt power, for 0.20 seconds, with 100 micrometer beam diameter. The beam was directed coaxially to the lash follicle to create a 2-3 mm crater and vaporization was observed. After crater formation, the laser parameters were changed to 1.2 watt power, for 0.20 seconds, with 200 micrometer beam diameter, to destroy residual follicular tissue. Up to five lashes were treated in one session. At the end of each session an antibiotic ointment was used t.i.d. for a week. RESULTS: Patients have been followed for 4-12 months (mean 6 months). Recurrences have been seen in 15 of 60 eyelids (25%). Laser treatment has been used with the same protocol for the cases with recurrence and results have been successful in eight of them. Postoperatively severe pain, hemorrhage, scar formation, neovascularization of lid margin, or infection were not seen in any patient. In three cases mild hypopigmentation and in three other cases mild lid notching were observed. CONCLUSIONS: Argon laser lash ablation can be done as an effective office procedure with topical anesthesia. The advantages include low recurrence and complication rates in carefully selected patients and minimal postoperative discomfort.

Adult↗

Thermoablation treatment for trichiasis in trachoma using the semiconductor diode pumped laser.

PURPOSE: The aim of this prospective study was to verify the efficacy of laser therapy for trichiasis in trachoma. Trichiasis is one of the most important complications of trachoma which is endemic in Sanliurfa, a city in the southeast of Turkey. METHODS: Twenty-eight eyelids of 22 patients - 15 males and 7 females - with trichiasis related to trachoma involving the upper, lower, or both lids, were included in the study and treated with a semiconductor diode-pumped, frequency-doubled, solid-state laser operating true CW at 532 nm. RESULTS: 19 (67.9%) of the lids were successfully treated in two sessions or less. Six lids (21.4%) required a third laser session and three (10.7%) a fourth session. Mild notching or dimpling occurred in two eyelids (5.6%). Postoperative swelling was minimal or absent. CONCLUSIONS: The results show that laser treatment may be successful for trichiasis caused by trachoma. Laser thermoablation is an effective and safe method, with many advantages over other modalities.

Aged↗