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. 2015 Nov 13;2015(11):CD004008. doi: 10.1002/14651858.CD004008.pub3

Burton 2005a.

Methods Study Design: parallel group randomised trial of peri‐operative azithromycin treatment
Eyes: only one eye per participant was included in the analysis. In bilateral cases, the eye with more severe baseline trichiasis was included.
Participants Country: The Gambia
Setting: health centres
 Number of participants: 451
 Lost to follow up: 25
Male: 133, Female: 318
A consecutive, geographically defined sub‐set of the original participants was followed‐up at 4 years.
Number of participants: 356
 Lost to follow up: 90
Male: 103, Female: 253
Major trichiasis cases only
Interventions (1) Posterior lamellar tarsal rotation surgery (no placebo)
 (2) Posterior lamellar tarsal rotation surgery followed by single‐dose azithromycin treatment at baseline and 6 months, administered to the patient and the members of their household
Outcomes Primary Outcome: recurrent trichiasis by one year
Secondary Outcomes: visual acuity by reduced LogMAR chart, conjunctival infection, corneal opacification
 Follow up: 12 months and 4 years (subset)
Notes Funder: International Trachoma Initiative
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote "Separate randomisation sequences were generated for each surgeon from random number tables and blocked in groups of four"
Allocation concealment (selection bias) Low risk Quote "Treatment allocations were concealed in opaque sequentially numbered envelopes"
Blinding of participants and personnel (performance bias) 
 All outcomes Low risk Quote "Immediately following surgery a nurse not involved in clinical assessments or surgery administered the randomly allocated treatment."
Participants were not masked to allocation, as no placebo was used.
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Quote "Examiners were ‘‘blinded’’ to treatment allocation."
Incomplete outcome data (attrition bias) 
 All outcomes Low risk 98% follow‐up of those still alive at 1 year.
At 4 years 94% of the surviving patients were re‐examined
Selective reporting (reporting bias) Low risk Clear analytical approach in methods.