Surgery versus epilation for the treatment of minor trichiasis in Ethiopia: A randomised controlled noninferiority trial

Abstract

Background: Trachomatous trichiasis can cause corneal damage and visual impairment. WHO recommends surgery for all cases. However, in many regions surgical provision is inadequate and patients frequently decline. Self-epilation is common and was associated with comparable outcomes to surgery in nonrandomised studies for minor trichiasis ( <0.001); there was no difference in change in visual acuity or corneal opacity between the two groups. Conclusions: This trial was inconclusive regarding inferiority of epilation to surgery for the treatment of minor trichiasis, relative to the prespecified margin. Epilation had a comparable effect to surgery on visual acuity and corneal outcomes. We suggest that surgery be performed whenever possible but epilation be used for treatment of minor trichiasis patients without access to or declining surgery. © 2011 Rajak et al.