Mtwara

Researchers are evaluating two surgical methods for repeat trichiasis surgery in individuals with post-operative trachomatous trichiasis (PTT) in Tanzania. This randomized clinical trial aims to determine whether the Bevel-Rotate Advancement Procedure (B-RAP) improves surgical success compared to the standard Bilamellar Tarsal Rotation (BLTR) surgery. The study plans to enroll 1,000 participants and will also assess eyelid contour changes and patient-reported outcomes over two years. Participants will be randomly assigned to receive either B-RAP or BLTR surgery. B-RAP involves a beveled incision toward the eyelashes to thin and rotate the eyelid fragment and remove scarring, while BLTR uses a full-thickness incision with sutures to rotate and fix the eyelid. Follow-up visits are scheduled at 1 day, 2 weeks, and 3, 6, 9, 12, 18, and 24 months after surgery to monitor outcomes. During the study, participants will undergo regular assessments to check for repeat trichiasis, eyelid contour abnormalities, and other complications such as pyogenic granuloma formation. Patient-reported outcomes will also be collected. The primary outcome measure is the number of eyelids with repeat postoperative trachomatous trichiasis within 12 months after surgery. Safety and effectiveness will be closely monitored throughout the two-year follow-up period.