Baseline Predictors for the Postoperative Trachomatous Trichiasis Following Lid Rotation Surgery in the FLuorometholone as Adjunctive MEdical Therapy for Trachomatous Trichiasis Surgery (FLAME) Trial

PURPOSE: To evaluate predictive factors for postoperative trachomatoustrichiasis (PTT) following trachomatous trichiasis (TT) surgery in an atrachoma-endemic setting. METHODS: Secondary analysis of the FLuorometholone as Adjunctive MEdicaltherapy for TT surgery (FLAME) trial for comparing fluorometholone 0.1% vs placebo as adjunctive therapy for TT surgery. A total of 3,218 upper eyelids from 2398 participants underwent posteriorlamellar (PLTR) or bilamellar (BLTR) tarsal rotation surgery and were assessed for PTT at week 4 and at months 6 and 12 post-surgery. PTT wasdefined as ≥1 lashes touching the globe, evidence of epilation, and/or repeat TT surgery. Baseline demographic and ocular characteristics were assessed for predicting 12-month PTT incidenceusing logistic regression, accounting for inter-eye correlation with generalized estimating equations. RESULTS: = 0.008) was independentlyassociated with a higher risk of PTT. These predictors and surgeons predicted PTT with an area under the curve of 0.74 (95% confidence interval: 0.72 to 0.77). CONCLUSIONS: Several baseline demographic and ocular characteristics indicating TT severity are predictive of PTT. Using these findings to identify high-risk individuals can inform clinical decision-making/patientcounselling.