People with trichiasis can expect to develop corneal opacity within several years if left untreated. Corneal opacity can result in permanent visual loss if it affects the visual axis.
variable
low
Likelihood is low with high-quality surgery.
Very high recurrence rates have been reported, but lower rates (≤10%) are achievable with meticulous surgical procedure.[64]West SK, West ES, Alemayehu W, et al. Single-dose azithromycin prevents trichiasis recurrence following surgery: randomized trial in Ethiopia. Arch Ophthalmol. 2006 Mar;124(3):309-14.
http://www.ncbi.nlm.nih.gov/pubmed/16534049?tool=bestpractice.com
[65]Woreta F, Munoz B, Gower E, et al. Three-year outcomes of the surgery for trichiasis, antibiotics to prevent recurrence trial. Arch Ophthalmol. 2012 Apr;130(4):427-31.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898462
http://www.ncbi.nlm.nih.gov/pubmed/22159169?tool=bestpractice.com
Adjunctive azithromycin given at the time of surgery may help decrease postoperative recurrence in areas with high levels of infection.[66]Zhang H, Kandel RP, Atakari HK, et al. Impact of oral azithromycin on recurrence of trachomatous trichiasis in Nepal over 1 year. Br J Ophthalmol. 2006 Aug;90(8):943-8.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1857215
http://www.ncbi.nlm.nih.gov/pubmed/16687452?tool=bestpractice.com
[67]Burton M, Habtamu E, Ho D, et al. Interventions for trachoma trichiasis. Cochrane Database Syst Rev. 2015 Nov 13;(11):CD004008.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004008.pub3/abstract
http://www.ncbi.nlm.nih.gov/pubmed/26568232?tool=bestpractice.com
Posterior lamellar tarsal rotation surgery is associated with significantly lower rates of recurrence than bilamellar tarsal rotation surgery.[63]Habtamu E, Wondie T, Tadesse Z et al. Posterior lamellar versus bilamellar tarsal rotation surgery for trachomatous trichiasis: Long-term outcomes from a randomised controlled trial. EClinicalMedicine. 2019 Nov 1 [Epub ahead of print].
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30201-9/fulltext
As surgery only corrects the architecture of the eyelid but does not alter the pathological process, which may continue, some degree of recurrence is probably inevitable due to the natural history of trachomatous trichiasis and the ongoing scarring of the tissue.