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Updated: Jun 12, 2026
03:59
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Trichiasis surgery in The Gambia: a 4-year prospective study
Saul N Rajak1, Pateh Makalo, Ansumana Sillah
1London School of Hygiene and Tropical Medicine, London, UK. saul.rajak@lshtm.ac.uk
Investigative Ophthalmology & Visual Science
|May 28, 2010
Summary
Recurrent trachiasis, a leading cause of infectious blindness, frequently recurs after surgery, often within six months. Persistent inflammation and severe baseline conditions increase the risk of trichiasis recurrence.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Global Health
Background:
- Trachoma, caused by Chlamydia trachomatis, is the primary infectious cause of blindness globally.
- Conjunctival scarring from trachoma leads to eyelid deformities (entropion, trichiasis) and corneal opacity, affecting millions.
- While trichiasis surgery aims to prevent blindness, long-term recurrence rates require further investigation.
Purpose of the Study:
- To prospectively evaluate the long-term recurrence rates of trichiasis following surgical intervention.
- To identify factors associated with trichiasis recurrence in a Gambian population over a 4-year period.
Main Methods:
- A 4-year prospective study involving 356 Gambian patients undergoing posterior lamellar tarsal rotation surgery for trichiasis.
- Clinical examinations and conjunctival swab collections for Chlamydia trachomatis (C. trachomatis) testing were performed at baseline, 6 months, 1 year, and 4 years.
Main Results:
- High recurrence rates were observed: 32% at 6 months, 40% at 1 year, and 41% at 4 years post-surgery.
- At 4 years, 30% of patients had bilateral trichiasis and 21% had bilateral corneal opacity.
- Severe baseline conjunctival inflammation and a higher number of trichiasis lashes (>10) were significantly associated with recurrence.
Conclusions:
- Trichiasis recurrence after surgery is common, with a majority of cases occurring within the first six months.
- Surgical technique and quality are critical factors that may influence recurrence rates.
- Persistent conjunctival inflammation is a strong predictor of long-term trichiasis recurrence.
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