Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial.
<h4>Background</h4>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....
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| Language: | English |
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Public Library of Science (PLoS)
2015-03-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0003558&type=printable |
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| 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 |
| collection | DOAJ |
| description | <h4>Background</h4>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.<h4>Methodology/ principal findings</h4>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.<h4>Conclusions/ significance</h4>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 |
| id | doaj-art-49a4d8c6ae8d40f3a81b4a7c1ab2ad11 |
| institution | Kabale University |
| issn | 1935-2727 1935-2735 |
| language | English |
| publishDate | 2015-03-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj-art-49a4d8c6ae8d40f3a81b4a7c1ab2ad112025-01-17T05:32:33ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352015-03-0193e000355810.1371/journal.pntd.0003558Epilation for minor trachomatous trichiasis: four-year results of a randomised controlled trial.Esmael HabtamuSaul N RajakZerihun TadesseTariku WondieMulat ZerihunBirhan GuadieTeshome GebreAmir Bedri KelloKelly CallahanDavid C W MabeyPeng T KhawClare E GilbertHelen A WeissPaul M EmersonMatthew J Burton<h4>Background</h4>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.<h4>Methodology/ principal findings</h4>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.<h4>Conclusions/ significance</h4>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.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0003558&type=printable |
| spellingShingle | 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. PLoS Neglected Tropical Diseases |
| title | 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_short | 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 |
| url | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0003558&type=printable |
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