Study of the gray line split procedure combined with amniotic membrane transplantation in the treatment of complex trichiasis

Abstract

Objective To investigate the effect of the gray line split procedure combined with amniotic membrane transplantation in the treatment of complex trichiasis. Methods The gray line of 27 eyes in 16 cases were splited from the lid margin of the trichiasis area with recession of the anterior lamella. Amniotic membrane was used to cover the bared tarsus and was sutured with 8-0 vicryl to skin superiorly and tarsus inferiorly. The followed-up time was 6 months. Results Complete success with no lashes touching the globe was achieved in 24 eyes of 13 cases (88.89%). The most common complication was hemorrhage below the graft in 3 eyes of 3 cases. Two eyes of 2 cases had recurrent trichiasis but was successfully treated with electrolysis. One eye with severe trachomatous upper lid entropion recurred at 5 months after surgery. Most of the amniotic membranes were well absorbed, although the amniotic membrane could not prevent tarsal shrinkage, but accelerated the epithelialization of bare tarsus within 2 to 3 weeks after surgery. Conclusion The gray line split procedure combined with amniotic membrane transplantation can help the bare tarsus epithelializing rapidly and seems to be a promising modality of treatment in patients with complex trichiasis. Key words: Trichiasis, complex; Amniotic membrane, transplantation; Margin, gray line