Evaluation of Effectiveness of Bilamellar Tarsal Rotation Surgery in Trachomatous Trichiasis-A Study from Nepal

Abstract

Background: WHO has recommended Bilamellar Tarsal Rotation (BLTR) surgery for Trachomatous Trichiasis. Though, several studies have addressed the success rate of this surgery, the reported success rate shows great variation. The aim of this study was to evaluate the effectiveness of Bilamellar Tarsal Rotation (BLTR) surgery in Trachomatous Trichiasis. Methods: This hospital based, prospective and interventional study was conducted at Geta Eye Hospital, Kailali, Far West Province of Nepal from February 15, 2005 to July 31, 2006 that included patients with Trachomatous Trichiasis undergoing BLTR surgery. Preoperative, operative and postoperative details were evaluated according to proforma. Patients were examined on 1st and 10th post-operative days and later between 6-9 months after surgery (1st follow-up) and between 14-17 months after surgery (2nd follow-up). Results: Altogether 67 patients were included in this study period. Out of total 99 lids with trichiasis, 85 lids underwent BLTR surgery. Among 85 lids that underwent BLTR surgery, 67 were of minor type and 18 were of major type of trichiasis. Recurrence of trichiasis was not found at 10th post operative day. At first follow-up, 5 (5.9%) lids had recurrence and at 2nd follow-up, 13 (15.3%) lids had recurrence of trichiasis. Among minor group of trichiasis 3 (4.5%) lids had recurrence at 1st follow-up and 10 (14.9%) lids had recurrence at 2nd follow-up. Similarly among major group of trichiasis, 2 (11.1%) lids had recurrence at 1st follow-up and 3 (16.7%) lids had recurrence at 2nd follow-up. Conclusion: BLTR surgery is simple, safe and successful. Recurrence of trachomatous trichiasis is common following BLTR surgery.