Trichiasis Surgery in London

Trichiasis Surgery in London

Treating lashes that grow inward

Trichiasis is the term given to lashes that grow inward towards the eye when the eyelid is in a normal position. A number of different conditions can cause the lashes to grow against the ey but these are not termed trichiasis. They include:

Entropion – where the eyelid is turned towards the eye making the normal lashes rub against it.
Epiblepharon – an extra fold of skin to the lower eyelid pushes the normal lashes towards the eye.
Distichiasis – an extra row of lashes on the inner margin of the eyelid are present that can rub against the eye.

Trichiasis is where none o the above conditions are present and one or more lashes are misdirected towards the eye. Trichiasis can cause the following symptoms:

Trichiasis is caused by:

Infection – Long standing (Chronic) infections such as Herpes Zoster eye disease can cause trichiasis. Trachoma which is a disease more prevalent in developing nations is known to cause trichiasis.

Eyelid inflammation – Trichiasis can develop in chronic blepharitis which is a common condition resulting in inflammation of the eyelid margin. The lashes become misdirected as a result on the long term inflammation.

Autoimmune conditions – Rare disorders affecting the skin and mucous membranes such as Steven Johnson’s syndrome and cicatricial pemphigoid can result in trichiasis with the eyelashes turning in..

Injury – Burns in particular affecting the eyelid can result in trichiasis and the misdirection of the eyelashes.

What you can expect during the procedure

Entropion

Depending on the number of ingrowing lashes causing trichiasis and their location along the eyelid the following procedures may be performed:

Electrolysis

this is where a fine probe that uses radiofrequencies is inserted into the lash root to ablate it and destroy the lash follicle. This prevents further eyelash growth from the eyelash root.

Cryosurgery

freezing of the eyelashes and follicles damages them and prevent further lash regrowth.

Lash root excision

an incision is made along the margin of the eyelid and the lash roots along the area of trichiasis are removed.

Wedge excision

if the trichiasis is in a localised area of the eyelid and there is laxity of the eyelid which is common with the ageing process, a section of the eyelid containing the area of trichiasis is removed and the remaining healthy eyelid stitched together again. ​

trichiasis

Why is trichiasis surgery done

Ingrowing lashes can be plucked or epilated but this only provides short term relief until they grow back. Ocular lubricants can also be used for comfort but the permanent treatment is usually surgery.

What are the risks?

Risks of trichiasis surgery include:

To know which risks most apply to you talk to your doctor to understand more about trichiasis surgery as well as the benefits and if they apply to you. This way you can decide with your doctor if trichiasis surgery is a good option.

How you prepare for trichiasis surgery

Before having trichiasis surgery you will meet your Oculoplastic surgeon such as Mr Ahmad Aziz in his London clinic who specialises in trichiasis surgery to discuss:
It is preferable to stop taking any blood thinner medication such as aspirin, ibuprofen, warfarin, apixiban and any other medication that can cause increased bleeding during trichiasis surgery. Your doctor will discuss these with you to ensure that it is safe for you to do so prior to your trichiasis surgery and will tell you how long before the operation. Stoping smoking several weeks before surgery can help improve the healing after trichiasis surgery. You should arrange for someone to take you home after the procedure and stay with you for the first night following the operation.

What you can expect before the procedure

Trichiasis surgery is usually done as a day case where you can go home the same day. Your surgeon will inject anaesthetic into your eyelids to numb the area and you can also have medication through a drip to help you relax depending on the surgery that is to be done.

EYE DOCTOR WITH CARE TAILORED TO YOU
OCULOPLASTIC SURGEON

What you can expect during the procedure

Depending on the number of ingrowing lashes causing trichiasis and their location along the eyelid the following procedures may be performed:

Electrolysis – this is where a fine probe that uses radiofrequencies is inserted into the lash root to ablate it and destroy the lash follicle. This prevents further eyelash growth from the eyelash root.

Cryosurgery – freezing of the eyelashes and follicles damages them and prevent further lash regrowth.

Lash root excision – an incision is made along the margin of the eyelid and the lash roots along the area of trichiasis are removed.

Wedge excision – if the trichiasis is in a localised area of the eyelid and there is laxity of the eyelid which is common with the ageing process, a section of the eyelid containing the area of trichiasis is removed and the remaining healthy eyelid stitched together again.

What you can expect after the procedure

After surgery you are monitored for complications. You are able to leave later that day to recuperate and begin the healing at home.
After surgery you may temporarily experience:

Your doctor will likely suggest you take the following steps after surgery:

Seek medical attention immediately if you experience any of the following:

What are the results of surgery?

Many patients are satisfied with the results of trichiasis surgery and benefit from a more natural appearance, better vision if the vision was affected. The results of the surgery can last a lifetime but for others the trichiasis may recur with time particularly if the process that caused the trichiasis is ongoing or if you have had just one treatment of electrolysis.
The bruising and swelling noticeably settle within 2 weeks resorting a more natural look giving you confidence in going out publicly and subtle swelling that the patient may notice will generally resolve over a period of 2 months in the majority of cases.
Scars from the surgery can take months to fully fade but should be within the skin crease or under the lashes and well covered. You should protect your eyelids from too much sun exposure as you should do for the rest of your skin.

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