AI Article Synopsis
- The World Health Organization highlights the need for effective management of postoperative trichiasis (PTT) to help eliminate blinding trachoma, leading to the development of the Bevel-Rotation Advancement Procedure (B-RAP) for repeat surgery cases.
- The B-RAP technique uses a beveled incision to reduce eyelid thickness, enabling better treatment of severely scarred eyelids and correcting eyelid contour abnormalities, which can complicate repeat surgeries.
- In a study, B-RAP produced promising results, with 84% of eyelids showing no recurrence of PTT after 3-6 months, suggesting that the procedure may improve outcomes for patients needing follow-up trichiasis surgeries.
Article Abstract
Introduction: The World Health Organization has identified management of postoperative trichiasis (PTT) as one of the key remaining areas of focus needed to eliminate blinding trachoma as a public health problem. We developed the Bevel-Rotation Advancement Procedure (B-RAP) to treat individuals who need repeat trichiasis surgery.
Methods: Scarring caused by trichiasis surgery can cause the eyelid to become thick and distorted, making repeat surgery more difficult. To minimize eyelid thickness following B-RAP, a beveled incision of the tarsus is made allowing a marginal rotation of the eyelash fragment. Dissection between the anterior and posterior lamellae above the beveled incision and removal of scar tissue allows the marginal rotation to be combined with a posterior lamellar advancement to treat severely scarred eyelids with PTT and eyelid contour abnormalities (ECAs).
Results: Two surgeons performed B-RAP on 44 eyelids of 30 patients with PTT. The number of prior trachomatous trichiasis (TT) surgeries ranged from 2 to more than 4. At the 3-6 months postoperative visit, 37 eyelids (84%) had no recurrence of PTT. Three eyelids had central lashes touching; the remaining eyelids with recurrent PTT had nasal and temporal lashes touching. Fifteen eyelids (34%) had ECAs, but only 1 was severe.
Conclusions: B-RAP was developed considering the altered eyelid anatomy found in the postsurgical eyelid with TT. Thinning of the eyelash fragment and removal of postoperative scar tissue improves the ability to advance and stabilize the eyelash fragment after external rotation. B-RAP shows promise as a procedure for improving outcomes of repeat trichiasis surgery.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571053 | PMC |
| http://dx.doi.org/10.1097/IOP.0000000000002055 | DOI Listing |
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