An assessment of potential factors associated with surgical success and improvement in visual acuity in community-based trichiasis surgery camps in the Busoga region of Eastern Uganda Open Access

Subbiah, Krishnaveni (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/g732d9463?locale=en
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Abstract

Background: Trichiasis surgery is a simple and quick procedure that can be performed by local trained nurses and healthcare professionals in order to treat trichiasis and prevent permanent blindness. Sightsavers Uganda currently supports trichiasis surgery in twelve trachoma hyper-endemic districts throughout the Busoga sub-region of Eastern Uganda.

Purpose: The objective of this study was to examine the potential predictor variables for successful trichiasis surgery and improvement in visual acuity across four districts in this sub-region.

Methods: Data was extracted by retrospective chart review of surgical records of patients who received surgical treatment at the March 2015 trichiasis camps across four districts of this region. Only patients who returned for 10-day follow-up examination after surgery were analyzed. Cross tabulations and percentage proportions were evaluated using Wald X2 test and Fisher's exact test. Univariate and multivariate associations between potential predictor variables and each of the two outcomes were assessed using logistic regression analysis.

Results: The data showed high TT surgical success of 92.7% and 10-day follow-up of 81.3%, among all operated eyes. Predictors of surgery success were surgery district, the eye operated and the operation type. The multivariate logistic regression model included these three terms, plus two interaction terms of district and eye operated, and district and operation type. Improvement in visual acuity was explained by surgery district, gender and signs of epilation prior to TT surgery, each independently and when take together.

Conclusions: Trichiasis surgery is successful in this endemic area of the Busoga region, however, the proportion percentages of success varies by district. Surgical outcome is not associated with improvement in visual acuity. Improvement in visual acuity after trichiasis surgery is marginal, if at all. The primary purpose of trichiasis surgery is to reduce the burden of lashes rubbing against the cornea in order to prevent irreversible blindness.

Table of Contents

TABLE OF CONTENTS

BACKGROUND.............................................................................1

INTRODUCTION...........................................................................6

METHODS...................................................................................8

Study design and participants

Chart review

Statistical Analysis

RESULTS...................................................................................13

Study Participants

Patient Demographics

TT Surgery

Clinical Characteristics, by surgery district

Successful TT surgery

Improvement in Visual Acuity

DISCUSSION.............................................................................18

REFERENCES..............................................................................22

TABLES.....................................................................................25

FIGURES...................................................................................35

APPENDICES..............................................................................37

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