Relationship between Immediate Post-Operative Appearance and 6-Week Operative Outcome in Trichiasis Surgery 英文参考文献.docVIP

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Relationship between Immediate Post-Operative Appearance and 6-Week Operative Outcome in Trichiasis Surgery 英文参考文献.doc

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Relationship between Immediate Post-Operative Appearance and 6-Week Operative Outcome in Trichiasis Surgery 英文参考文献

RelationshipbetweenImmediatePost-Operative Appearanceand6-WeekOperativeOutcomeinTrichiasis Surgery ShannathL.Merbs1*,JenniferC.Harding1,2,SandraD.Cassard1,2,BeatrizE.Munoz1,2,SheilaK.West1,2 , EmilyW.Gower3 1DepartmentofOphthalmology,WilmerEyeInstitute,JohnsHopkinsUniversitySchoolofMedicine,Baltimore,Maryland,UnitedStatesofAmerica,2DanaCenterfor PreventiveOphthalmology,JohnsHopkinsUniversitySchoolofMedicine,Baltimore,Maryland,UnitedStatesofAmerica,3DepartmentofEpidemiologyandPrevention, WakeForestSchoolofMedicine,Winston-Salem,NorthCarolina,UnitedStatesofAmerica Abstract Background: Surgical technique, including suture placement and tension, is believed to contribute to the outcome of bilamellar tarsal rotation surgery for trachomatous trichiasis. However, the immediate post-operative appearance that minimizesthechanceofrecurrenceandotheradverseoutcomeshasnotbeeninvestigated. Methodology/PrincipalFindings:Toexplorewhetherthedegreeofcorrectionimmediatelyaftersurgeryispredictiveof surgical outcome at the 6-week post-operative visit, photographs taken immediately after surgery were used to predict surgical outcomes, including the severity of eyelid contour abnormality and trichiasis recurrence. Both eyelid contour abnormalities and recurrence were accurately predicted from the immediate post-operative photographs by an experienced oculoplastic surgeon 85% and 70% of the time, respectively. Participants with a ‘‘slight over-correction’’ thatresultedinnoeyelidcontourabnormalityandnorecurrencewereusedtoidentifyimmediatepost-operativecontours thatleadtoasuccessfulsurgicaloutcome. Conclusions/Significance:Theimmediatepost-operativeeyelidcontourisanimportantindicatorofpost-operativesuccess of BLTR surgery. Based upon our findings, we developed a Surgery Photocard. This card illustrates some examples of immediatepost-surgicalappearances,whichledtoasuccessfuloutcome,aswellassub-optimalappearances,whichledto poor surgical outcomes. The card also provides suggestions for impr