%0 Journal Article
%T Epilation for Minor Trachomatous Trichiasis: Four-Year Results of a Randomised Controlled Trial
%A Amir Bedri Kello
%A Birhan Guadie
%A Clare E. Gilbert
%A David C. W. Mabey
%A Esmael Habtamu
%A Helen A. Weiss
%A Kelly Callahan
%A Matthew J. Burton
%A Mulat Zerihun
%A Paul M. Emerson
%A Peng T. Khaw
%A Saul N. Rajak
%A Tariku Wondie
%A Teshome Gebre
%A Zerihun Tadesse
%J -
%D 2015
%R 10.1371/journal.pntd.0003558
%X Background Trachomatous trichiasis (TT) needs to be managed to reduce the risk of vision loss. The long-term impact of epilation (a common traditional practice of repeated plucking of lashes touching the eye) in preventing visual impairment and corneal opacity from TT is unknown. We conducted a randomized controlled trial of epilation versus surgery for the management of minor TT (fewer than six lashes touching the eye) in Ethiopia. Here we report the four-year outcome and the effect on vision and corneal opacity.   Methodology/ Principal Findings 1300 individuals with minor TT were recruited and randomly assigned to quality trichiasis surgery or repeated epilation using high quality epilation forceps by a trained person with good near vision. Participants were examined six-monthly for two-years, and then at four-years after randomisation. At two-years all epilation arm participants were offered free surgery. At four-years 1151 (88.5%) were re-examined: 572 (88%) and 579 (89%) from epilation and surgery arms, respectively. At that time, 21.1% of the surgery arm participants had recurrent TT; 189/572 (33%) of the epilation arm had received surgery, while 383 (67%) declined surgery and had continued epilating (ˇ°epilation-onlyˇ±). Among the epilation-only group, 207 (54.1%) fully controlled their TT, 166 (43.3%) had minor TT and 10 (2.6%) had major TT (>5 lashes). There were no differences between participants in the epilation-only, epilation-to-surgery and surgery arm participants in changes in visual acuity and corneal opacity between baseline and four-years.   Conclusions/ Significance Most minor TT participants randomised to the epilation arm continued epilating and controlled their TT. Change in vision and corneal opacity was comparable between surgery and epilation-only participants. This suggests that good quality epilation with regular follow-up is a reasonable second-line alternative to surgery for minor TT for individuals who either decline surgery or do not have immediate access to surgical treatment
%K Cornea
%K Surgical and invasive medical procedures
%K Opacity
%K Visual acuity
%K Eyes
%K Visual impairments
%K Cataract surgery
%K Trachoma
%U https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003558