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Background: Following the implementation of the SAFE strategy in Jigawa state, ophthalmic nurses trained as lid surgeons perform trichiasis surgery in the state. This study aimed to determine the early outcome of these surgeries with the specific objectives to determine the recurrence rate of trichiasis; the incidence of eyelid contour abnormality and incidence of eyelid closure defects 3–6 months postoperatively. Methods: A retrospective cohort study of patients operated for the first time between December 2012 and April 2013 in four zones in Jigawa state. Zones were selected based on the location of the most active surgeons. Patients were examined with torchlight for presence of recurrent trichiasis (TT recurrence), eyelid contour abnormality (ECA) and eyelid closure defects (ECD). Results: 133 eyes of 77 patients were examined; incidences recorded were TT recurrence 17.29% (95% CI 11.29–24.80%), ECA 18.93% (95% CI 12.64–26.67%) and ECD 5.3% (95% CI 2.15–10.62%). Incidence of poor outcome varied with zone and was associated with female sex, duration of symptoms >1 year preoperatively, bilaterally operated eyes, and paid surgery. Conclusion: The incidence of poor outcome measures was high across all zones evaluated. The risk factors associated with poorer outcome include late presentation, female sex, Bilateral surgery, and paid surgery.

Aim : To compare determinants for recurrence of trichiasis at one and two years following lid surgery in Vietnam. Study Design : Community-based intervention study. Methods : This study was carried out between 2000 and 2003 in four trachoma-endemic districts of Vietnam. Trained trichiasis surgeons performed modified Cuenod Nataf lid surgery on 648 eyes of 472 patients with Trachomatous trichiasis (TT). Trained investigators collected information on ocular and lid status before surgery and at one and two years following surgery. Trichiasis recurrence was calculated after adjusting for one or both eyes of each operated individual. Results : Fifty-six eyes developed recurrence at one year with adjusted prevalence of 8.8% (95% CI 6.60-11.01). One hundred and one eyes [15.9% (95% CI 13.04-18.72)] had recurrence two years following surgery. Female gender, older age group, study area, severe grade of trachomatous scarring (TS), past history of lid surgery, postoperative suture adjustment and surgeon were risk factors for recurrence at the end of one year. Study area and previous lid surgery were risk factors for recurrence in the second year. Recurrence at one year could be predicted if study area and severity of Trachomatous Scarring (TS) are known. Conclusions : One and two year recurrence rates with modified Cuenod Nataf lid surgeries for TT in Vietnam were acceptably low. Early recurrence could be reduced by proper case selection. However, late recurrence seems to be dependent on interaction of risk factors. Only age of the patient was the reliable predictor of recurrence.

The paper is a prospective study of 23 lids of 20 patients with upper lid aponeurotic ptosis operated using microincision technique in period 2005-2008. There were 7 males and 13 females. Age of the patients was 28-83 years (y), average 61 +/- 17 y, for female 63 +/- 13.4 y and for male 61 +/- 19 y. Inclusion criteria were: aponeurotic upper lid ptosis more than 2 mm, no other lid abnormalities, minimal dermatochalasis, no previous or concomitant lid surgery. The procedure was performed in local anesthesia through 10 mm cut. Aponeurosis was fixated to the tarsal plate with two sutures. Success was considered if operated lid height differed up to 0.5 mm of the other eye and margin-to-reflex distance was 2-4 mm in primary position. Postoperative results regarding contour, skin crease and lash position were good in all patients. Regarding height, 19/23 (83%) met criteria of 0.5 mm of the other eye and MRD 2-4 mm. In one bilateral procedure there was an asymmetry of 1 mm. Three patients with unilateral procedure had at least 1mm asymmetry comparing to the other eye. Reoperation was neccessary in two bilateral cases. Lid fold was symmetrical only in 7 patients (35%). The rest had slight to grose lid fold asymmetry. Complications were scarce, in early postoperative period there was hematoma in two patients lasting up to three weeks. Late failure was noticed in two cases 6 and 8 months postoperatively. Advantages are: less anesthetic results in less decreased levator function and more accurate assessment of eyelid position intraoperatively, less distortion of the lid due to less bleeding and edema, shorter operation time, less scarring and shortened recovery time. However it can be used only in selective cases.