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Kathleen C. Oktavec, Jennifer C. Harding, Sandra D. Cassard, Shannath L. Merbs, Beatrice Munoz, Sheila K. West, Emily W. Gower; Patients' Perception of Trichiasis Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):68.
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Trachomatous trichiasis requires timely surgical intervention, and if left uncorrected, trauma from trichiasis and secondary bacterial infection can lead to visual loss and blindness from corneal opacification. We sought to elucidate participants’ opinions regarding surgery and its outcomes.
A subset of participants enrolled in the ongoing Partnership for the Rapid Elimination of Trachoma (PRET) Surgery trial was invited to participate in a survey focused on evaluating patient perceptions of trichiasis surgery outcomes. All PRET participants living in the Mtwara District were invited to participate during their 24 month follow up visit in July 2011. A questionnaire specific to this study was designed and a pilot was tested. Following pilot testing with key informants, the final version was administered. A trained interviewer administered the questionnaire in the local language to study participants. The questionnaire included a series of inquiries to assess perceived post-surgical outcomes and included questions regarding ocular symptoms, daily functioning, appearance, and overall perception of surgery. Questions were typically presented as yes/no questions, with further querying of affirmative responses to determine the degree of problem or the level of satisfaction.
All 518 individuals invited to participate completed the questionnaire. Over 95% of patients stated the surgery improved some of the eye problems they were experiencing. 43% reported continuing eye problems, with blurred vision, foreign body sensation, and tearing being the most common. Of the 5% (24/518) of patients still experiencing pain, most stated the pain had been reduced by the surgery. Almost all participants stated their vision improved, with nearly 70% noting substantial improvement. 70% of patients stated their appearance was "a lot better." The majority (82%) felt the surgery improved their daily life. If necessary, 88% would undergo repeat surgery, and 98% would recommend the surgery to others. 7% had at least one complaint about the surgery itself, and 11% stated that getting surgery created problems. Caring for children, cooking, and farming were the main responsibilities that made it difficult for the participants to undergo surgery. In addition, several individuals expressed difficulties with not having a caretaker following surgery.
In the context of a free surgical program that provided transportation to the surgical site, patients were generally pleased with the outcomes of surgery, and almost all would recommend the surgery to others. Further analyses will investigate differences in responses for patients with successful surgery versus those who had trichiasis recurrence or eyelid contour abnormalities after surgery.
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