Surgery for trichiasis by ophthalmologists versus integrated eye care workers - A randomized trial
Surgery for trichiasis by ophthalmologists versus integrated eye care workers - A randomized trial
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DOI：
10.1016/j.ophtha.2003.06.030
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发表时间：
2004-03-01
期刊：
影响因子：
13.7
通讯作者：
Fantaye, D
中科院分区：
文献类型：
--
作者：
Alemayehu, W;Melese, M;Fantaye, D
目的：比较眼科医生与综合眼科护理人员（IECWs）治疗双层跗骨旋转（BTR）倒睫的疗效。设计：随机前瞻性干预性试验。参与者：埃塞俄比亚中部982名不同程度沙眼倒睫患者。方法：选取埃塞俄比亚中部3个州（区）的沙眼倒睫患者为研究对象。倒睫严重程度分级。患者由2名眼科医生和2名IECWs随机分配至手术组。术后第7天，评估患者矫形不足或其他并发症。如果出现倒睫，则认为手术失败（技术失败），患者被排除在随访研究之外，但进行了重复手术。第7天矫正良好的患者于第3、6个月再次检查。术后1年、2年和3年计划进一步随访评估。主要观察指标：复发率、不同级别的复发率差异、眼科手术与非眼科手术的差异。结果：随访第3个月，713例（73.0%）手术患者能定位。713例患者中有81例（11.4%）和1286例手术患者中有94例（5.4%）在此期间复发倒睫。在基线时，复发与严重程度分级呈线性趋势(chi(2) = 22.017， P
Objective: To study the outcome of bilamellar tarsal rotation (BTR) trichiasis surgery performed by ophthalmologists versus that done by integrated eye care workers (IECWs).Design: Randomized prospective interventional trial.Participants: Nine hundred eighty-two patients with various degrees of trachomatous trichiasis in central Ethiopia.Methods: Trachomatous trichiasis patients in 3 woredas (districts) in central Ethiopia were enrolled. Trichiasis severity was graded. Patients were randomly assigned to surgery by 2 ophthalmologists and 2 IECWs. On the seventh day postoperatively, patients were evaluated for undercorrection or other complications. If trichiasis was present, it was considered a failure of surgery (technical failure), and patients were excluded from the follow-up study, but repeat surgery was performed. Those patients with good correction at the seventh day were examined again on the third and sixth months. Further follow-up evaluation is planned for the first, second, and third years postoperatively.Main Outcome Measures: Recurrence rate, recurrence difference in the various grades, and difference between surgeries done by ophthalmic surgeons and those done by IECWs.Results: In the third month of follow-up, it was possible to locate 713 (73.0%) of the operated patients. Eighty-one of 713 (11.4%) individuals and 94 of 1286 (5.4%) operated lids developed recurrent trichiasis in this period. There was a linear trend of recurrence with grading (severity) at baseline (chi(2) = 22.017, P