Trichiasis, inturned eyelashes that abrade the eye, is the leading infectious cause of blindness globally, affecting over 7 million individuals. While surgery is available to correct trichiasis, more than 20% experience post-operative trichiasis needing further surgical management. Yet current management procedures for post-operative trichiasis are poor. The primary objective of this randomized clinical trial is to determine whether repeat trichiasis surgery performed with a new, novel surgical procedure, the Bevel/Rotate/Advance Procedure (BRAP) improves surgical success compared to the current procedure, Trabut. This trial will be conducted in southern Ethiopia as an additional aim to an existing, ongoing project, the Maximizing Trichiasis Surgery Success (MTSS) Trial. Pairing this study with the MTSS trial will result in significant cost and time savings while maximizing the benefits to MTSS enrollees. All MTSS participants who present with post-operative trichiasis at their 12-month visit will be invited to participate. We anticipate 700 individuals will be enrolled and randomized on a 1:1 basis to surgery with RAP versus surgery with Trabut. The primary outcome will be second post-operative trichiasis within 6 months after surgery. If this project is successful in improving surgical outcomes, it could change the approach to treating post-operative trichiasis globally. Additionally, individuals with trichiasis have a significantly reduced quality of life; correcting their trichiasis long-term has the potential to improve their quality of life and their family members? quality of life considerably.
Post-operative trichiasis is a condition in which eyelashes turn inwards and abrade the eye after initial surgical correction, and current methods for treating it are suboptimal. In this project, we will investigate two surgical methods for treating post-operative trichiasis, with the hopes of improving the quality of the lives of the millions of patients affected by this blinding condition. By preventing blindness through appropriate surgical correction, we ultimately may will help to break the cycle of poverty that afflicts the millions of families burdened by this disease.
