Objetivo: O objetivo do presente trabalho foi promover o ensino do tracoma, assim como atuar no combate esta desta importante causa de cegueira evitável. Métodos: Esta proposta foi aprovada pelo Ministério da Saúde (Programa PET-Saúde/Vigilância em Saúde), prevendo o treinamento em serviço de alunos de graduação em Medicina e Enfermagem e agentes de saúde, no município de Botucatu, São Paulo-Brasil, no ano de 2010. O treinamento abrangeu parte teórica e prática, a qual constou de estudo transversal, por amostragem aleatorizada, para estudo da prevalência do tracoma inflamatório em escolares de 1 a a 4 a séries do ensino público fundamental, seguindo os critérios da Organização Mundial de Saúde (OMS) e com supervisão de dois oftalmologistas com certificação para o diagnóstico clínico. Os dados obtidos foram analisados estatisticamente. A equipe foi avaliada quanto ao aprendizado. Resultados: O trabalho de campo mostrou que a prevalência de tracoma em crianças do município de Botucatu no ano de 2010 foi de 3,42%. A notificação compulsória, a pesquisa dos comunicantes, aplicação do tratamento para os afetados e o seguimento conforme padronizado aconteceu com a participação ativa da equipe. Conclusão: A prevalência do tracoma inflamatório em Botucatu no ano de 2010 foi de 3,42%. As atividades desenvolvidas pelos participantes do Programa PET-Saúde/Vigilância em Saúde-Tracoma permitiu treinamento em serviço efetivo, resultando na formação de multiplicadores, uma força adicional na luta pela eliminação do tracoma como causa de cegueira.

The purpose of this article is to analyze the outcomes of two surgical techniques to treat major trichiasis. A retrospective chart review of 67 patients (89 eyelids) with major trichiasis was performed who underwent surgical treatment using one of two techniques: intermarginal split lamella with graft (ISLG group) or lid lamella resection (LLR group). There were 30 lids in the ISLG group with mean patient age of 71.8 years and 63.3% were females. There were 59 lids in the LLR group with mean patient age of 72.5 years and 52.5% were female. The minimum postoperative follow up was six months. Statistical analysis included descriptive measures, Goodman association test for contrasts between and within multinomial populations and nonparametric Mann-Whitney test for comparison between groups. P < 0.05 was considered statistically significant. The underlying causes of trichiasis were blepharitis (37.07%), chronic meibomitis (21.3%), multiple causes (20.2%), ectropion (11.2%), actinic keratosis (6.7%), or prior ocular surgery (3.3%). Postoperatively, in the ISLG group, there were 20% lids with complete success, 50% underwent laser or electrolysis, 16.7% required further surgery, and 13.3% were unsuccessful. Postoperatively, in the LLR group, there were 47.5% eyelids with complete success, 46.7% underwent laser or electrolysis, 6.8% required further surgery, and 5.1% were unsuccessful. There was a higher statistical chance of complete success with LLR (P < 0.05). LLR is superior to ISLG surgery for the treatment of major trichiasis. There is a greater chance of success with LLR and it is technically simpler.

No abstract

Purpose: To validate the standard values and evaluate the success rate in the treatment of minor and major trichiasis using thermoablation with a diode green laser. Methods: In this interventional prospective study, individuals with minor or major trichiasis who were treated with thermoablation using diode green laser were included. The patients’ mean age was 72.1 years; the majority were females (54.1%) and Caucasian (98%). The parameters of the diode laser were wavelength of 532 nm, application time of 200 ms, target size of 50 μm, interval between the shots 150 to 200 ms, and power of 600 to 750 mW. The number of shots was defined by the depth of ablation sufficient to reach the pilus hair bulb. The patients were evaluated by slit-lamp every 3 to 4 months, for up to 15 months. The treatment success rate and the association between variables were analyzed. Results: The study sample was comprised of 98 patients with 135 affected lids and 337 lashes with trichiasis. Minor trichiasis (91.8%), unilateral trichiasis (67.3%), trichiasis affecting the lower eyelid (85.9%), and trichiasis resulting from blepharitis (64.3%) were the most common presentation profiles. The overall cure rate at the end of the study was 85%, with 69% being cured with a single session and 82.8% with two treatment sessions. Conclusion: Thermoablation using a diode green laser applying the specified parameters to treat minor and major trichiasis is effective and results in high cure rate.

No abstract