The prevention and management of postoperative trachomatous trichiasis: A systematic review
Among ocular infections, trachoma is the main cause of blindness. Repeated conjunctival Chlamydia trachomatis infections lead to trichiasis, corneal opacification, and visual impairment. Surgery is often needed to relieve discomfort and preserve vision; however, a high postoperative trachomatous tri...
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| Veröffentlicht in: | Survey of ophthalmology 2024-01, Vol.69 (1), p.93-102 |
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| creator | Kreis, Andreas J. Gower, Emily W. Kropp, Martina Kello, Amir B. Nouhoum, Guirou Resnikoff, Serge Talero, Sandra L. Solomon, Anthony W. |
| description | Among ocular infections, trachoma is the main cause of blindness. Repeated conjunctival Chlamydia trachomatis infections lead to trichiasis, corneal opacification, and visual impairment. Surgery is often needed to relieve discomfort and preserve vision; however, a high postoperative trachomatous trichiasis (PTT) rate has been observed in various settings. We wanted to know why, whether PTT rates could be reduced, and how to manage the PTT that occurs. We performed a search of the literature. Of 217 papers screened, 59 studies were identified for inclusion as potentially relevant, the majority having been excluded for not directly concerning PTT in humans. Preventing PTT is a major challenge. Only one published trial, the STAR trial in Ethiopia, has reported a cumulative PTT rate |
| doi_str_mv | 10.1016/j.survophthal.2023.02.008 |
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Repeated conjunctival Chlamydia trachomatis infections lead to trichiasis, corneal opacification, and visual impairment. Surgery is often needed to relieve discomfort and preserve vision; however, a high postoperative trachomatous trichiasis (PTT) rate has been observed in various settings. We wanted to know why, whether PTT rates could be reduced, and how to manage the PTT that occurs. We performed a search of the literature. Of 217 papers screened, 59 studies were identified for inclusion as potentially relevant, the majority having been excluded for not directly concerning PTT in humans. Preventing PTT is a major challenge. Only one published trial, the STAR trial in Ethiopia, has reported a cumulative PTT rate <10% one year after surgery. The literature on the management of PTT is sparse. Though no PTT management guidelines are available, high-quality surgery with a low rate of unfavorable outcomes for PTT patients is likely to require enhanced training of a smaller group of highly-skilled surgeons. Based on the surgical complexity and the authors’ own experience, the pathway for patients suffering from PTT should be studied further for improvement.</description><identifier>ISSN: 0039-6257</identifier><identifier>EISSN: 1879-3304</identifier><identifier>DOI: 10.1016/j.survophthal.2023.02.008</identifier><identifier>PMID: 36878359</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Blindness ; Conjunctiva ; Humans ; Postoperative Trachomatous Trichiasis ; PTT ; Systematic Review ; Trachoma ; Trachoma - complications ; Trachoma - prevention & control ; Trichiasis - etiology ; Trichiasis - surgery ; Vision, Low</subject><ispartof>Survey of ophthalmology, 2024-01, Vol.69 (1), p.93-102</ispartof><rights>2023 The Author(s)</rights><rights>Copyright © 2023 The Author(s). Published by Elsevier Inc. 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Repeated conjunctival Chlamydia trachomatis infections lead to trichiasis, corneal opacification, and visual impairment. Surgery is often needed to relieve discomfort and preserve vision; however, a high postoperative trachomatous trichiasis (PTT) rate has been observed in various settings. We wanted to know why, whether PTT rates could be reduced, and how to manage the PTT that occurs. We performed a search of the literature. Of 217 papers screened, 59 studies were identified for inclusion as potentially relevant, the majority having been excluded for not directly concerning PTT in humans. Preventing PTT is a major challenge. Only one published trial, the STAR trial in Ethiopia, has reported a cumulative PTT rate <10% one year after surgery. The literature on the management of PTT is sparse. Though no PTT management guidelines are available, high-quality surgery with a low rate of unfavorable outcomes for PTT patients is likely to require enhanced training of a smaller group of highly-skilled surgeons. Based on the surgical complexity and the authors’ own experience, the pathway for patients suffering from PTT should be studied further for improvement.</description><subject>Blindness</subject><subject>Conjunctiva</subject><subject>Humans</subject><subject>Postoperative Trachomatous Trichiasis</subject><subject>PTT</subject><subject>Systematic Review</subject><subject>Trachoma</subject><subject>Trachoma - complications</subject><subject>Trachoma - prevention & control</subject><subject>Trichiasis - etiology</subject><subject>Trichiasis - surgery</subject><subject>Vision, Low</subject><issn>0039-6257</issn><issn>1879-3304</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1PwzAMhiMEgjH4CyjcuLTko21SbmjiS0LiAicOUZq6NNPalCQb2r8naIA4crJsv35tPwidU5JTQqvLZR7WfuOmPvZ6lTPCeE5YTojcQzMqRZ1xTop9NCOE11nFSnGEjkNYEkIKXotDdMQrKSQv6xl6fe4BTx42MEbrRqzHFg961G8wpAp2HZ5ciG4Cr6PdAI5em94NOrp1SIk1vdXBhit8jcM2REgda3Dys_Bxgg46vQpw-h3n6OX25nlxnz0-3T0srh8zwwWLmTBlJQRtKJeFAMYLLRtZcwagq1K0XdVRWkresKKUrGAUSFGBLEWTvusk6_gcXex8J-_e1xCiGmwwsFrpEdKZiglZJO8qmc5RvZMa70Lw0KnJ20H7raJEfbFVS_WHrfpiqwhTiW2aPftes24GaH8nf2AmwWIngPRsAuBVMBZGA631YKJqnf3Hmk-lSJIQ</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Kreis, Andreas J.</creator><creator>Gower, Emily W.</creator><creator>Kropp, Martina</creator><creator>Kello, Amir B.</creator><creator>Nouhoum, Guirou</creator><creator>Resnikoff, Serge</creator><creator>Talero, Sandra L.</creator><creator>Solomon, Anthony W.</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7977-0029</orcidid></search><sort><creationdate>202401</creationdate><title>The prevention and management of postoperative trachomatous trichiasis: A systematic review</title><author>Kreis, Andreas J. ; Gower, Emily W. ; Kropp, Martina ; Kello, Amir B. ; Nouhoum, Guirou ; Resnikoff, Serge ; Talero, Sandra L. ; Solomon, Anthony W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-7c56771b13847e234a8b8932eea657df6f11583b24582421e046e857b039f82f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Blindness</topic><topic>Conjunctiva</topic><topic>Humans</topic><topic>Postoperative Trachomatous Trichiasis</topic><topic>PTT</topic><topic>Systematic Review</topic><topic>Trachoma</topic><topic>Trachoma - complications</topic><topic>Trachoma - prevention & control</topic><topic>Trichiasis - etiology</topic><topic>Trichiasis - surgery</topic><topic>Vision, Low</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kreis, Andreas J.</creatorcontrib><creatorcontrib>Gower, Emily W.</creatorcontrib><creatorcontrib>Kropp, Martina</creatorcontrib><creatorcontrib>Kello, Amir B.</creatorcontrib><creatorcontrib>Nouhoum, Guirou</creatorcontrib><creatorcontrib>Resnikoff, Serge</creatorcontrib><creatorcontrib>Talero, Sandra L.</creatorcontrib><creatorcontrib>Solomon, Anthony W.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Survey of ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kreis, Andreas J.</au><au>Gower, Emily W.</au><au>Kropp, Martina</au><au>Kello, Amir B.</au><au>Nouhoum, Guirou</au><au>Resnikoff, Serge</au><au>Talero, Sandra L.</au><au>Solomon, Anthony W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The prevention and management of postoperative trachomatous trichiasis: A systematic review</atitle><jtitle>Survey of ophthalmology</jtitle><addtitle>Surv Ophthalmol</addtitle><date>2024-01</date><risdate>2024</risdate><volume>69</volume><issue>1</issue><spage>93</spage><epage>102</epage><pages>93-102</pages><issn>0039-6257</issn><eissn>1879-3304</eissn><abstract>Among ocular infections, trachoma is the main cause of blindness. 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| language | eng |
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| subjects | Blindness Conjunctiva Humans Postoperative Trachomatous Trichiasis PTT Systematic Review Trachoma Trachoma - complications Trachoma - prevention & control Trichiasis - etiology Trichiasis - surgery Vision, Low |
| title | The prevention and management of postoperative trachomatous trichiasis: A systematic review |
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