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Updated: Jun 8, 2026

Surgical Correction for Pediatric Epiblepharon and Trichiasis

Surgical Correction for Pediatric Epiblepharon and Trichiasis

Published on: July 8, 2025

Quality assurance in trichiasis surgery: a methodology.

John C Buchan¹, Hans Limburg, Matthew J Burton

¹Kissy UMC Eye Hospital, PO Box 115, 41 East Kissy Bye-Pass Road, Freetown, PMB 8803, Sierra Leone. johnbuchan@gmail.com

The British Journal of Ophthalmology

|October 1, 2010

Summary

This study introduces a Lot Quality Assurance sampling method to audit individual surgeons performing trachomatous trichiasis (TT) surgery. This approach helps identify surgeons with high recurrence rates, enabling targeted retraining to improve outcomes and combat trachoma blindness.

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Area of Science:

Ophthalmology
Public Health
Surgical Audit

Background:

Trachoma is a leading cause of preventable blindness globally.
Trachomatous trichiasis (TT) surgery is crucial for preventing blindness, but challenges exist in ensuring surgical quality.
Current trachoma control programs lack effective mechanisms for auditing individual surgeon performance and identifying poor outcomes.

Purpose of the Study:

To propose and evaluate a methodology for individual surgeon-level surgical audit for TT.
To implement a system for identifying surgeons with unacceptably high recurrence rates of TT.

Main Methods:

Utilizing Lot Quality Assurance (LQA) sampling to assess TT recurrence.
Examining a set number of previously operated patients to detect recurrent TT.

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Published on: July 8, 2025

Categorizing surgeons as 'high recurrence' or 'low recurrence' based on findings.

Main Results:

The proposed LQA methodology allows for confident categorization of TT surgeons.
Defines a clear pathway to identify surgeons with high TT recurrence rates.
Establishes a data-driven approach for surgical quality assessment in TT control programs.

Conclusions:

The LQA-based audit system can effectively identify surgeons needing intervention.
This methodology guides management in implementing retraining or other remedial actions.
Aims to improve surgical outcomes and contribute to the elimination of trachoma blindness.