Using data from a large randomized trial, investigators analyzed intra- and post-operative factors that are vital in shaping trichiasis surgery outcomes.

This secondary analysis included 1,000 patients with trachomatous trichiasis (TT) who underwent bilamellar tarsal rotation (BLTR) or posterior lamellar tarsal rotation (PLTR). Postoperatively, patients were evaluated for recurrent trichiasis, eyelid contour abnormalities and granuloma formation at 6 and 12 months by masked graders.

Factors protective of postoperative TT recurrence included:

• Extending the length of the incision medially and laterally for both PLTR and BLTR
• Peripherally dissecting with scissors in PLTR and BLTR
• External incision height of <4 mm in BLTR

Contour abnormalities were more often observed with suture interval asymmetry of >2 mm in PLTR. Irregular posterior lamellar incision at the center of the eyelid in PLTR resulted in granuloma formation.