This analysis relies on data from the Partnership for Rapid Elimination of Trachoma (PRET) Surgery trial. PRET is a randomized, masked clinical trial comparing outcomes following BLTR surgery using either standard instrumentation or the TT clamp [18] (link). Sutures were removed two weeks post-operatively. Six weeks, 12 months and 24 months after surgery, participants were examined for trichiasis recurrence, ECAs, and pyogenic granuloma formation. Field grades were recorded for each outcome at each visit. Photographs were taken pre-operatively, immediately post-operatively, and at each follow-up visit. For the current analysis, photographs from the six-week visit were utilized.
Photographs were taken in a standardized fashion. All follow up photographs were taken with the patient seated and the camera lens nine inches from the patient's superior orbital rim. Patients were asked to keep their head facing forward, but to look up as high as they could so that the upper eyelid margin could be seen. At the start of the PRET trial, one of the senior photograph graders (SLM) trained the field grader on classification of ECAs. At that time, we classified ECAs as mild or severe. However, during the course of developing the grading system, after the completion of the six-week period and the start of the one year follow-up period, we determined we could more finely delineate severity categories. In order to be able to directly compare the 6-week field and photograph grades, photographs graded as moderate or severe were combined into a single category called severe when comparing the field and photograph grades.
Photographs were taken in a standardized fashion. All follow up photographs were taken with the patient seated and the camera lens nine inches from the patient's superior orbital rim. Patients were asked to keep their head facing forward, but to look up as high as they could so that the upper eyelid margin could be seen. At the start of the PRET trial, one of the senior photograph graders (SLM) trained the field grader on classification of ECAs. At that time, we classified ECAs as mild or severe. However, during the course of developing the grading system, after the completion of the six-week period and the start of the one year follow-up period, we determined we could more finely delineate severity categories. In order to be able to directly compare the 6-week field and photograph grades, photographs graded as moderate or severe were combined into a single category called severe when comparing the field and photograph grades.
Free full text: Click here
