[Argon laser trichiasis treatment: Technique, indications and results (report of 230 cases)]

Trichiasis is a common misdirection of the eyelashes, creating a sharp point responsible for decreased vision, blepharospasm and corneal irritation. It may cause neurotrophic corneal disease leading to blindness. The etiology of trichiasis remains largely undetermined in our patient base. Treatment is based on pragmatic methods that take into account the ciliary ecosystem and the static and dynamic examination of the eyelids. For this, several therapeutic modalities exist: mechanical epilation, cryotherapy, surgery and electrolysis. Each of these techniques has its indications, advantages, and complications. Destruction of the lash follicles with argon laser has many advantages: it is an outpatient procedure, rapid, reproducible, well tolerated, and above all, effective in the long term. The aim of our study is to examine the advantages, technique, indications and results of argon laser trichiasis treatment. This was a retrospective study including 201 patients (230 eyelids) treated in our ophthalmology department over a period of 9years (from January 2011 to March 2020), all of whom were seen for various lash-related symptoms and treated with argon laser electrolysis. Results were considered satisfactory when no lash regrowth occurred within six months of the last laser session. Eighty-two percent of our patients (n=188) showed a good therapeutic response after the first session, 9% (n=21) needed an additional session, and only 6% of the patients (n=14) required a 3rd and/or 4th session, without resorting to surgery. The indications for this treatment should be limited to trichiasis of fewer than or equal to 7 per eyelid, without associated lid malposition (entropion), the treatment of which should be surgical and entirely different. Treatment of trichiasis with argon laser can be an alternative or complement to surgery. Results are excellent but require rigorous adherence to the technique and indications.