Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial.
BACKGROUND:Trachomatous trichiasis (TT) needs to be managed to reduce the risk of vision loss. The long-term impact of epilation (a common traditional practice of repeated plucking of lashes touching the eye) in preventing visual impairment and corneal opacity from TT is unknown. We conducted a rand...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2015
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0003558 https://doaj.org/article/49a4d8c6ae8d40f3a81b4a7c1ab2ad11 |
id |
ftdoajarticles:oai:doaj.org/article:49a4d8c6ae8d40f3a81b4a7c1ab2ad11 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:49a4d8c6ae8d40f3a81b4a7c1ab2ad11 2023-05-15T15:15:53+02:00 Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial. Esmael Habtamu Saul N Rajak Zerihun Tadesse Tariku Wondie Mulat Zerihun Birhan Guadie Teshome Gebre Amir Bedri Kello Kelly Callahan David C W Mabey Peng T Khaw Clare E Gilbert Helen A Weiss Paul M Emerson Matthew J Burton 2015-03-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0003558 https://doaj.org/article/49a4d8c6ae8d40f3a81b4a7c1ab2ad11 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC4358978?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0003558 https://doaj.org/article/49a4d8c6ae8d40f3a81b4a7c1ab2ad11 PLoS Neglected Tropical Diseases, Vol 9, Iss 3, p e0003558 (2015) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2015 ftdoajarticles https://doi.org/10.1371/journal.pntd.0003558 2022-12-31T12:31:37Z BACKGROUND:Trachomatous trichiasis (TT) needs to be managed to reduce the risk of vision loss. The long-term impact of epilation (a common traditional practice of repeated plucking of lashes touching the eye) in preventing visual impairment and corneal opacity from TT is unknown. We conducted a randomized controlled trial of epilation versus surgery for the management of minor TT (fewer than six lashes touching the eye) in Ethiopia. Here we report the four-year outcome and the effect on vision and corneal opacity. METHODOLOGY/ PRINCIPAL FINDINGS:1300 individuals with minor TT were recruited and randomly assigned to quality trichiasis surgery or repeated epilation using high quality epilation forceps by a trained person with good near vision. Participants were examined six-monthly for two-years, and then at four-years after randomisation. At two-years all epilation arm participants were offered free surgery. At four-years 1151 (88.5%) were re-examined: 572 (88%) and 579 (89%) from epilation and surgery arms, respectively. At that time, 21.1% of the surgery arm participants had recurrent TT; 189/572 (33%) of the epilation arm had received surgery, while 383 (67%) declined surgery and had continued epilating ("epilation-only"). Among the epilation-only group, 207 (54.1%) fully controlled their TT, 166 (43.3%) had minor TT and 10 (2.6%) had major TT (>5 lashes). There were no differences between participants in the epilation-only, epilation-to-surgery and surgery arm participants in changes in visual acuity and corneal opacity between baseline and four-years. CONCLUSIONS/ SIGNIFICANCE:Most minor TT participants randomised to the epilation arm continued epilating and controlled their TT. Change in vision and corneal opacity was comparable between surgery and epilation-only participants. This suggests that good quality epilation with regular follow-up is a reasonable second-line alternative to surgery for minor TT for individuals who either decline surgery or do not have immediate access to surgical treatment. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 9 3 e0003558 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Esmael Habtamu Saul N Rajak Zerihun Tadesse Tariku Wondie Mulat Zerihun Birhan Guadie Teshome Gebre Amir Bedri Kello Kelly Callahan David C W Mabey Peng T Khaw Clare E Gilbert Helen A Weiss Paul M Emerson Matthew J Burton Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Trachomatous trichiasis (TT) needs to be managed to reduce the risk of vision loss. The long-term impact of epilation (a common traditional practice of repeated plucking of lashes touching the eye) in preventing visual impairment and corneal opacity from TT is unknown. We conducted a randomized controlled trial of epilation versus surgery for the management of minor TT (fewer than six lashes touching the eye) in Ethiopia. Here we report the four-year outcome and the effect on vision and corneal opacity. METHODOLOGY/ PRINCIPAL FINDINGS:1300 individuals with minor TT were recruited and randomly assigned to quality trichiasis surgery or repeated epilation using high quality epilation forceps by a trained person with good near vision. Participants were examined six-monthly for two-years, and then at four-years after randomisation. At two-years all epilation arm participants were offered free surgery. At four-years 1151 (88.5%) were re-examined: 572 (88%) and 579 (89%) from epilation and surgery arms, respectively. At that time, 21.1% of the surgery arm participants had recurrent TT; 189/572 (33%) of the epilation arm had received surgery, while 383 (67%) declined surgery and had continued epilating ("epilation-only"). Among the epilation-only group, 207 (54.1%) fully controlled their TT, 166 (43.3%) had minor TT and 10 (2.6%) had major TT (>5 lashes). There were no differences between participants in the epilation-only, epilation-to-surgery and surgery arm participants in changes in visual acuity and corneal opacity between baseline and four-years. CONCLUSIONS/ SIGNIFICANCE:Most minor TT participants randomised to the epilation arm continued epilating and controlled their TT. Change in vision and corneal opacity was comparable between surgery and epilation-only participants. This suggests that good quality epilation with regular follow-up is a reasonable second-line alternative to surgery for minor TT for individuals who either decline surgery or do not have immediate access to surgical treatment. |
format |
Article in Journal/Newspaper |
author |
Esmael Habtamu Saul N Rajak Zerihun Tadesse Tariku Wondie Mulat Zerihun Birhan Guadie Teshome Gebre Amir Bedri Kello Kelly Callahan David C W Mabey Peng T Khaw Clare E Gilbert Helen A Weiss Paul M Emerson Matthew J Burton |
author_facet |
Esmael Habtamu Saul N Rajak Zerihun Tadesse Tariku Wondie Mulat Zerihun Birhan Guadie Teshome Gebre Amir Bedri Kello Kelly Callahan David C W Mabey Peng T Khaw Clare E Gilbert Helen A Weiss Paul M Emerson Matthew J Burton |
author_sort |
Esmael Habtamu |
title |
Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial. |
title_short |
Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial. |
title_full |
Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial. |
title_fullStr |
Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial. |
title_full_unstemmed |
Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial. |
title_sort |
epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2015 |
url |
https://doi.org/10.1371/journal.pntd.0003558 https://doaj.org/article/49a4d8c6ae8d40f3a81b4a7c1ab2ad11 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 9, Iss 3, p e0003558 (2015) |
op_relation |
http://europepmc.org/articles/PMC4358978?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0003558 https://doaj.org/article/49a4d8c6ae8d40f3a81b4a7c1ab2ad11 |
op_doi |
https://doi.org/10.1371/journal.pntd.0003558 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
9 |
container_issue |
3 |
container_start_page |
e0003558 |
_version_ |
1766346222324416512 |