Baseline Predictors for the Postoperative Trachomatous Trichiasis Following Lid Rotation Surgery in the FLuorometholone as Adjunctive MEdical Therapy for Trachomatous Trichiasis Surgery (FLAME) Trial
Le résumé fourni par la source
To evaluate predictive factors for postoperative trachomatoustrichiasis (PTT) following trachomatous trichiasis (TT) surgery in an atrachoma-endemic setting. Secondary analysis of the FLuorometholone as Adjunctive MEdicaltherapy for TT surgery (FLAME) trial for comparing fluorometholone 0.1% vs placebo as adjunctive therapy for TT surgery. A total of 3,218 upper eyelids from 2398 participants underwent posteriorlamellar (PLTR) or bilamellar (BLTR) tarsal rotation surgery and were assessed for PTT at week 4 and at months 6 and 12 post-surgery. PTT wasdefined as ≥1 lashes touching the globe, evidence of epilation, and/or repeat TT surgery. Baseline demographic and ocular characteristics were assessed for predicting 12-month PTT incidenceusing logistic regression, accounting for inter-eye correlation with generalized estimating equations. By 12 months, 431 upper eyelids (13.4%) developed PTT. Increasing age (adjusted odds ratio (aOR) = 1.93 for 60+ vs ≤29 years, p < 0.001), severe pre-operative TT (aOR = 2.01 for epilation >2/3 eyelid vs 1–5 lashes touching globe, p < 0.001), higher Ocular Surface Disease Indexocular symptoms score (aOR = 2.05 for 75–100 vs 0–12, p = 0.003), presence of TT at the lower eyelid (aOR = 1.96, p = 0.003), corneal opacity (aOR = 2.15 for off-center faint opacity vs none, p = 0.047), and surgery type (aOR = 3.85 for BLTR vs PLTR, p = 0.008) was independentlyassociated with a higher risk of PTT. These predictors and surgeons predicted PTT with an area under the curve of 0.74 (95% confidence interval: 0.72 to 0.77). Several baseline demographic and ocular characteristics indicating TT severity are predictive of PTT. Using these findings to identify high-risk individuals can inform clinical decision-making/patientcounselling.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.