Lagophthalmos surgery in leprosy: findings from a population-based survey in Korea

Lagophthalmos continues to be a serious problem in cured leprosy patients. We conducted a population-based survey of lagophthalmos surgical coverage ( LSC), barriers to lagophthalmos surgery and outcome of lagophthalmos surger y in leprosy patients in South Korea. In our survey, there were 60 patients with lagophthalmos who had needed surgery (> 5 mm. gap), 34 of whom had re ceived surgery, resulting in a lagophthalmos surgery coverage of 57%. Among the 34 patients who had received lagophthalmos surgery, 18 needed further surgery. Among those who had never had surgery, none of the demographic ind icators predicted surgical uptake; the primary reason given for failure to have surgery was lack of knowledge about it. Outcome of surgery (by eye) sh owed that 29% of eyes still had a gap of 5 mm or more. The frequency of sym ptoms (tearing, blurring of vision, pain, etc.) was high. Even in settings with a good eye care infrastructure, such as Korea, uptake of surgery can s till be low and results may not be satisfactory to patients. There is a nee d for practical guidelines for leprosy control programmes in the areas of ( a) patient recognition, (b) patient education, (c) monitoring the uptake of surgery, and (d) monitoring the outcome of surgery to ensure the best poss ible outcome.