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Tinsay A. Woreta, MD, MPH; Beatriz E. Munoz, MSc; Emily W. Gower, PhD; Wondu Alemayehu, MD; Sheila K. West, PhD

Arch Ophthalmol. 2009;127(11):1505-1510.

Objectives  To determine the effect of trichiasis surgery on visual acuity.

Methods  A total of 439 participants in the Surgery for Trichiasis, Antibiotics to Prevent Recurrence (STAR) trial had visual and subjective concerns measured before and 6 months after surgery. Trichiasis surgery was performed in at least 1 eye by integrated eye care workers. Visual acuity was measured using illiterate E versions of Early Treatment Diabetic Retinopathy Study charts with standardized, forced-choice procedures. Improvement was defined as improvement in visual acuity greater than 1 line (5 letters).

Results  The mean improvement in visual acuity for the eyes that had surgery was 0.129 logMAR units (P < .001). Surgery was associated with improvement in visual acuity compared with no surgery (odds ratio, 1.68; 95% confidence interval, 1.04-2.70). Independent predictors of visual acuity improvement in the eyes that had surgery included the number of lashes touching the globe prior to surgery and baseline visual acuity. Among patients, 93.8% described significant pain and 90.4% significant photophobia at baseline compared with only 1.4% and 0.9%, respectively, following surgery.

Conclusions  Surgery to correct trichiasis appears to provide significant visual acuity improvement as well as a decrease in subjective concerns in patients with trachomatous trichiasis.

Trial Registration  clinicaltrials.gov Identifier: NCT00347776

Author Affiliations: Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland (Drs Woreta, Gower, and West, and Ms Munoz); Project ORBIS Ethiopia, Addis Ababa, Ethiopia (Dr Alemayehu).

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