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.