Mtwara

Researchers are evaluating two surgical techniques for repeat eyelid surgery in people with post-operative trachomatous trichiasis PTT in Tanzania. This randomized trial aims to see if the Bevel-Rotate Advancement Procedure B-RAP improves outcomes compared to the standard Bilamellar Tarsal Rotation BLTR surgery. The study will include 1,000 individuals undergoing repeat trichiasis surgery and will track results to help improve treatment approaches globally. Participants will be randomly assigned to receive either the B-RAP procedure, which involves a beveled incision to thin and rotate the eyelid fragment, or the BLTR procedure, which uses a full-thickness incision and sutures to rotate and fix the eyelid. Surgery will be performed by trained Integrated Eye Care Workers, with follow-up visits scheduled at 1 day, 2 weeks, and 3, 6, 9, 12, 18, and 24 months after surgery to monitor progress. Throughout the study, researchers will evaluate whether repeat trichiasis occurs within 12 months post-surgery as the main outcome. They will also assess eyelid contour abnormalities, pyogenic granuloma formation, and patient-reported outcomes over two years. Safety and effectiveness will be monitored carefully during this period to understand which technique leads to better long-term results.