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Results for “Trichiasis”

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PubMed1984

X-ray epilation for the treatment of trichiasis.

.richiasis is a complication of many different disorders of the eyelids. Treatment is difficult and painful when conventional methods of plucking, surgical excision, electrolysis, or cryotherapy are employed. Since superficial x-ray therapy for the treatment of eyelid skin cancers causes permanent loss of the eyelashes in the irradiated field, we attempted to exploit this observation for the treatment of trichiasis. A rabbit model was used to determine the minimum permanent epilating dose. The dose was found to be approximately 4,000 rad of superficial radiation along with the following factors: 110 kV, 10 mamp, a target skin distance of 20 cm, a half-value layer of 1.0 mm of aluminum, and no filter. The dosage schedule used was 300 rad given three times per week. Two patients with severe scarring trichiasis were treated with the same factors and a total dose of 4,000 rad; excellent results were achieved. We believe that x-ray therapy is an easy, safe, and painless method for the management and cure of chronic trichiasis.

Animals↗

PubMed1997

[Trachomatous entropion trichiasis at the ophthalmologic clinic of Dantec CHU (apropos of 199 cases)].

In Senegal as well as others developing countries trachoma is a real public health problem. Entropion trichiasis is its most common and its most blinding complication. The authors made a retrospective study on 137 records of patients who underwent 199 surgical cures on a two years period. Epidemiologically, the average age is 49 years with a significative higher percentage of woman. Clinically, 51.5% of the patients had already complications, mostly on the cornea. The Trabut technique was the most used and its results was good in 82.4% cases. The authors underlined the duality of entropion trichiasis characterized by the ocular morbidity linked to the corneal damages and the simplicity of the surgical treatment which present definite advantages. Meanwhile they remind that the best treatment of the entropion trichiasis remains the prophylaxy of trachoma.

Adolescent↗

PubMed2000

[Treatment of trichiasis with a diode laser].

BACKGROUND: Various methods have been used in the treatment of trichiasis: epilation, excision, cryosurgery, thermocaustic needle, and argon laser. None of these is satisfactory. Based on the principle of selective photothermolysis for destroying specifically the hair follicle, we used a diode laser and evaluated its efficacy. MATERIAL AND METHODS: Nineteen eyes with 301 itching lashes were treated in three sessions at intervals of 1 week. In each session the single hair follicle received laser energy of 20 J/cm2 at a frequency of 806 nm for 15 ms. We used a bare fiber of 0.8 mm at a distance of 2 mm from the follicle. RESULTS: After 4 months two-thirds of the hairs were destroyed. The regrown lashes, however, are lighter and softer than the original ones. This treatment is less painful than all others. The laser is small, easy to use, and inexpensive. CONCLUSIONS: The diode laser is a useful tool for the treatment of trichiasis. The laser parameters, however, should be ameliorated.

Eyelashes↗

PubMed2005

Eyelid splitting with follicular extirpation using a monopolar cautery for the treatment of trichiasis and distichiasis.

PURPOSE: To assess the efficacy of eyelid splitting coupled with follicular extirpation via monopolar cautery in the treatment of trichiasis and distichiasis. METHODS: Between March 2000 and October 2003, this surgery was performed on 52 eyelids from 45 patients, with a mean follow-up period of 14.3 months (ranging from 12.3 to 17.6 months) . Under local anesthesia and a surgical microscope, a chalazion clamp is positioned on the eyelid, and a no. 11 scalpel is employed to make an incision located immediately anterior and parallel to the abnormal eyelash line. Each of the abnormal hair follicles is then removed via cautery with a monopolar needle. No sutures are involved in this procedure. RESULTS: Forty-four eyelids of 40 patients (84.6%) were successfully treated without recurrence or any residual symptoms. Repeat surgery was then performed on eight eyelids, with successful results in six cases. The cumulative success rate for this procedure was 96.1%. No complications were noted in the treated area, including lid deformities, granuloma formation, infections, and others. CONCLUSIONS: Eyelid splitting coupled with follicular extirpation via cautery with a monopolar needle, a procedure which requires no sutures, constitutes a simple and effective method for the treatment of both trichiasis and distichiasis and is associated with favorable functional and cosmetic results.

Adolescent↗

PubMed2006

Recurrence of trachomatous trichiasis 17 years after bilamellar tarsal rotation procedure.

PURPOSE: In 1989, World Health Organization consultant operated on trachomatous trichiasis (TT) cases in Dhakhiliya region of Oman. We evaluated their current ocular status. DESIGN: This was an historic cohort study. METHODS: This study was conducted in an in-house setting. Ninety-one patients with TT who underwent operation by the bilamellar tarsal rotation procedure (BTR) were our study population. Their preoperative, operative, and immediate postoperative data were retrieved from the register. Staff members located and visited these patients. They examined the eyes and determined their visual, TT, and corneal status. They interviewed participants with a close-ended questionnaire to assess the quality of life and satisfaction for the TT services that were offered. RESULTS: Sixty-three patients could be followed. Among 72 eyes that had undergone operation 17 years earlier, the recurrence rate was 47.2% (95% CI, 35.7-58.8). In 21 unoperated eyes (55%), TT was noted. The association of TT recurrence to age, gender, type of TT, conjunctivitis, and active trachoma was tested. The BTR for minor trichiasis was the risk factor for recurrence of TT (adjusted odds ratio, 3.9; 95% CI, 1.4-10.8). CONCLUSION: The high recurrence rate of TT, 17 years after BTR surgery and high rates of TT in eyes that did not undergo surgical procedure earlier suggest that the causes of high recurrence should be identified and addressed. The ongoing pathologic condition of scarring of upper lids of both operated and unoperated eyes could be responsible for lid status after 17 years of BTR surgeries. High percentage of refusals because of long-term high recurrence could pose a challenge to reach the "elimination of blinding trachoma" by 2020.

Eyelashes↗

PubMed2000

Corneal amyloidosis complicated by trichiasis. Immunohistochemical identification of the amyloid light chain protein

Purpose: To identify the amyloid protein of the corneal amyloidosis complicated by trichiasis.Methods: The two patients were 41-year-old and 38-year-old women with trichiasis. They had gelatinous drop-like corneal change in the hemilateral eye. The lesion was excised and examined by light and electron microscopy. Additionally, we performed an immunohistochemical study with immunofluorescence techniques using cryosections.Results: The amyloid deposits were confirmed with light and electron microscopy. Congo red positive staining was not reduced following pretreatment with potassium permanganate. Immunohistochemically, amyloid deposits in the cornea stained positively with serum human light chain kappa and lambda. Pretreatment of the section with 0.05% Tween-20 did not decrease the staining with fluorescence. The deposits stained negatively with serum prealbumin and keratin antibodies.Conclusions: These findings indicate the protein of the corneal amyloidosis complicating trichiasis to be an amyloid light chain (AL) protein that has never been identified in this kind of corneal amyloidosis.

Journal Article↗

PubMed2005

Risk of trachomatous scarring and trichiasis in Gambians varies with SNP haplotypes at the interferon-gamma and interleukin-10 loci.

Experimental evidence implicates interferon gamma (IFNgamma) in protection from and resolution of chlamydial infection. Conversely, interleukin 10 (IL10) is associated with susceptibility and persistence of infection and pathology. We studied genetic variation within the IL10 and IFNgamma loci in relation to the risk of developing severe complications of human ocular Chlamydia trachomatis infection. A total of 651 Gambian subjects with scarring trachoma, of whom 307 also had potentially blinding trichiasis and pair-matched controls with normal eyelids, were screened for associations between single-nucleotide polymorphisms (SNPs), SNP haplotypes and the risk of disease. MassEXTEND (Sequenom) and MALDI-TOF mass spectrometry were used for detection and analysis of SNPs and the programs PHASE and SNPHAP used to infer haplotypes from population genetic data. Multivariate conditional logistic regression analysis identified IL10 and IFNgamma SNP haplotypes associated with increased risk of both trachomatous scarring and trichiasis. SNPs in putative IFNgamma and IL10 regulatory regions lay within the disease-associated haplotypes. The IFNgamma +874A allele, previously linked to lower IFNgamma production, lies in the IFNgamma risk haplotype and was more common among cases than controls, but not significantly so. The promoter IL10-1082G allele, previously associated with high IL10 expression, is in both susceptibility and resistance haplotypes.

Alleles↗

PubMed1990

[Technic and long-term results of cryogenic epilation in trichiasis and distichiasis].

The present paper communicates the technique and results of cryoepilation in 1,690 cases (94% trichiasis and 6% distichiasis). Only nitrogen cryotherapy devices are totally suitable for this, and the spray freezing method is to be preferred. The IKG unit developed by the authors, which has proved successful in particular for tumor therapy, is also ideal for cryoepilation. It generates a very tightly bundled nitrogen spray jet, thus permitting isolated freezing of the lid margin. In about 95% of the cases permanent epilation is achieved without undue trauma. In 5% the condition described by Fraunfelder as "secondary trichiasis" develops. Ocular pemphigoid is not a contraindication to cryotherapy.

Cryosurgery↗

PubMed2006

Barriers to acceptance of intervention among patients with trachomatous trichiasis or entropion presenting to a teaching hospital.

PURPOSE: To determine the barriers to therapeutic intervention in patients with trachomatous trichiasis or entropion. METHODS: Prospective study over one year in 60 patients with trachomatous trichiasis or entropion presenting to a teaching hospital. The outcome measure was reported barriers to uptake of intervention using a questionnaire. The data were analysed using chi-square and Fisher's exact tests. Patient characteristics were correlated with barriers using univariate and multivariate analysis. RESULTS: The major barriers (operative in > 60% of patients) were illiteracy (66.7%), ignorance regarding treatment (65.0%), and fear of surgery (63.3%). Duration of symptoms in 43 females and 17 males ranged from 0.5 to 240 months (mean 30.2 +/- 45.82). Females reported significantly more barriers (average 5.8 +/- 1.88) than males (average 4.6 +/- 1.97; p = 0.03). Shorter duration was significantly related to perceived expense (p = 0.008). Patients aged =55 years more often cited young children as a barrier (p = 0.02). CONCLUSIONS: Encouraging patients who have undergone intervention to share their experiences with community members, providing intervention in patients' villages, community involvement with patients who live alone and making gender-sensitive medical programmes might be useful in reducing the fear of surgery and enhancing awareness and uptake of intervention. Future studies must identify barriers in their regions so that attempts can be directed to overcoming them so as to reduce the blinding and non-blinding burden of trachoma.

Adult↗

PubMedDate not supplied

Routine bilamellar tarsal rotation surgery for trachomatous trichiasis: short-term outcome and factors associated with surgical failure.

PURPOSE: To determine risk factors for early failure of the bilamellar tarsal rotation procedure in trachomatous trichiasis. METHODS: This was a prospective study in which the bilamellar tarsal rotation procedure was performed on 638 eyelids in Menofiya governorate in Egypt over a 4-year period. An analysis was performed to determine the incidence of early surgical failure (defined as one or more lashes touching the eyeball) after 8 weeks and to determine the risk factors for these failures. RESULTS: Follow-up data were available on 599 eyes at 8 to 10 weeks after surgery. Considering all eyes, failure (one or more lashes touching the eyeball) was noted in 98 eyes (16.4%). Failure was associated with preoperative corneal staining (RR, 3.27; 95% CI, 2.34 to 4.57), preoperative corneal opacity (RR, 1.64; 95% CI, 1.15 to 2.34), the use of silk sutures (RR, 54.82; 95% CI, 7.72 to 389.4), and the use of 4 or more sutures (RR, 1.24; 95% CI, 1.04 to 1.48). CONCLUSIONS: The finding that specific sutures or needles was associated with early failure of the bilamellar tarsal plate rotation procedure for trachomatous trichiasis was unexpected and deserves further study.

Blepharoplasty↗

PubMedDate not supplied

Treatment of trichiasis using an 810-nm diode laser: an efficacy study.

PURPOSE: To determine the efficacy of an 810-nm diode laser in the treatment of trichiasis. METHODS: Noncomparative interventional prospective study of 87 patients, providing 153 eyelids with darkly pigmented trichiatic eyelashes, treated with the 810-nm diode laser. The number of trichiatic eyelashes was counted before and after treatment. Patients were followed for 6 months with monthly examinations. RESULTS: Immediately after laser treatment, the average number of trichiatic eyelashes per patient was reduced from 3.50 (standard deviation, 4.20) to 0.40 (standard deviation, 1.0). Forty-one patients were followed for 3 or more months (minimum of 90 days; maximum, 443 days; standard deviation, 77.23 days). Among these patients, the average number of eyelashes per patient was reduced from 3.58 (standard deviation, 4.15) to 0.73 (standard deviation, 1.60). The paired t tests demonstrated a statistically significant difference between numbers of eyelashes before and after laser treatment irrespective of gender, age, or location of eyelashes. CONCLUSIONS: The 810-nm diode laser is an effective tool in treating trichiasis.

Adult↗

PubMed1990

Thermoablation treatment for trichiasis using the argon laser.

This paper presents a brief review of the literature regarding current treatment modalities for trichiasis and their complications. The technique of Argon laser thermoablation of lashes is described. A total of 12 patients with recurrent trichiasis involving 15 eyelids were treated and the procedure was found to be effective in 12 eyelids (80%). The follow-up period was three to six months. The laser settings used were Argon blue-green wavelength, spot size 50 to 100 microns, exposure time 0.05 to 0.10 seconds and power 1200 to 2000 mW. Advantages of the technique were precise application and selectivity, lack of complications, non-requirement for infiltrative anaesthesia and ease of performance. Disadvantages were the need for up to three treatments in some patients and the technique only being suitable for treating small numbers (up to six) of lashes.

Aged↗

PubMed1981

Scleral homograft inlay for correction of cicatricial entropion and trichiasis.

In the management of trachomatous cicatricial entropion and trichiasis numerous surgical options are available to the surgeon, who, however, must choose the correct technique suitable to the severity of the condition. In general, severe cases do better with a graft of mucous membrane or skin. In this paper the use of another graft material, homologous sclera, in correcting entropion and trichiasis is discussed. A 1.5 to 2 mm wide strip of fresh or preserved sclera was used as an inlay in a grey-line split technique with severance of pretarsal and Riolan's fibres in 155 entropion corrections in 136 patients. There was a success rate of 92.3% during the observation period of 15 months. Isolated trichiatic lashes were seen in 7.7%. Minor complications occurred, such as granulomas and partial sloughing of grafts, but did not affect the ultimate results.

Adult↗

PubMed1988

Morphological observations on patients with presumed trichiasis.

The clinical findings in 116 patients with a provisional diagnosis of trichiasis are presented. In 69% a small degree of entropion producing lash-globe contact was detected. The term lid border entropion is proposed for this condition, which is recognised clinically by conjunctivalisation of the meibomian gland orifices and anterior placement of the mucocutaneous junction. These features were clearly demonstrated by electron microscopy of a biopsy specimen from one patient. An analysis of other causes of trichiasis is discussed and an attempt is made to clarify the terminology currently in use.

Adult↗

PubMed1987

Secondary localized amyloidosis of the cornea caused by trichiasis.

A 43-year-old woman complained of gradual visual impairment, foreign body sensation, and a white mass in the right eye. Trichiasis and corneal excrescence were observed. A systemic examination revealed no concurrent disease; the family history was noncontributory. A lamellar keratoplasty was performed. An amyloid deposit was found in the excised specimen histopathologically. Secondary localized amyloidosis of the cornea caused by trichiasis is a rare condition.

Adult↗

PubMedDate not supplied

Excision of individual follicles for the management of congenital distichiasis and localized trichiasis.

This paper presents a brief review of the literature regarding congenital distichiasis. The literature is confusing regarding the term distichiasis. Distichiasis should be utilized to describe congenital partial or complete accessory rows of eyelashes which exit from the posterior lid margin behind the meibomian gland orifices. The term acquired trichiasis and congenital distichiasis are significantly different. This paper also describes a new method for microscopically dissecting and excising the follicles of distichiatic eyelashes. The technical details of the surgical procedure are described with appropriate illustrations. This procedure can also be utilized for removal of localized areas of acquired trichiasis. The advantage of this procedure over previously utilized procedures for congenital distichiasis is the lower incidence of recurrent distichiatic lashes, combined with complete preservation of normal eyelashes and essentially no risk of cicatricial entropion following this procedure.

Eyelashes↗

PubMed1976

Neglected lid deformities causing progressive corneal disease. Surgical correction of entropion, trichiasis, marginal keratinization, and functional lid shortening.

The potentially blinding abrasive deformities of the lids--trichiasis, districhiasis, entropion, and marginal keratinization--and the defects in lid closure resulting from functionally shortened upper or lower lids should be corrected surgically before contact lenses are fitted or corneal grafting undertaken. The choice of procedure for surgical correction of various degrees of trichiasis-entropion is indicated by the various associated findings, such as thickness of tarsal plate, presence of functional shortening of the upper lid, and involvement of the lower lid (Table II).

Congenital Abnormalities↗

PubMed1978

Cryosurgery for trichiasis.

A series of 41 cases of trichiasis was treated with cryosurgery using a standard retinal cryoprobe. The failure rate was approximately 50 per cent. The results should be improved by using properly designed equipment capable of cooling the lash follicles to -20 degrees C, and ensuring that this temperature is achieved by using a tissue thermocouple. A double freeze-thaw cycle should be used and a long-acting local anaesthetic containing adrenaline. The main complication is depigmentation which is a problem only with heavily pigmented patients. Cryosurgery does have potential for the treatment of trichiasis.

Adolescent↗