Impact of Trichiasis surgery on physical functioning in Ethiopian patients: STAR trial

Am J Ophthalmol. 2011 May;151(5):850-7. doi: 10.1016/j.ajo.2010.10.039. Epub 2011 Feb 17.


Purpose: To evaluate the physical functioning of Ethiopian trichiasis surgery patients before and 6 months after surgery.

Design: Nested cohort study.

Methods: This study was nested within the Surgery for Trichiasis, Antibiotics to Prevent Recurrence (STAR) clinical trial conducted in Ethiopia. Demographic information, ocular examinations, and physical functioning assessments were collected before and 6 months after surgery. A single score for patients' physical functioning was constructed using Rasch analysis. A multivariate linear regression model was used to determine if change in physical functioning was associated with change in visual acuity.

Results: Of the 438 participants, 411 (93.8%) had both baseline and follow-up questionnaires. Physical functioning scores at baseline ranged from -6.32 (great difficulty) to +6.01 (no difficulty). The percentage of participants reporting no difficulty in physical functioning increased by 32.6%; the proportion of participants in the mild/no visual impairment category increased by 8.6%. A multivariate linear regression model showed that for every line of vision gained, physical functioning improves significantly (0.09 units; 95% CI: 0.02-0.16).

Conclusions: Surgery to correct trichiasis appears to improve patients' physical functioning as measured at 6 months. More effort in promoting trichiasis surgery is essential, not only to prevent corneal blindness, but also to enable improved functioning in daily life.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living*
  • Anti-Bacterial Agents / administration & dosage
  • Azithromycin / administration & dosage
  • Case-Control Studies
  • Ethiopia / epidemiology
  • Eyelids / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Care
  • Secondary Prevention
  • Sickness Impact Profile
  • Single-Blind Method
  • Surveys and Questionnaires
  • Trichiasis / drug therapy
  • Trichiasis / epidemiology
  • Trichiasis / surgery*
  • Visual Acuity / physiology


  • Anti-Bacterial Agents
  • Azithromycin