Excision of individual follicles for the management of congenital distichiasis and localized trichiasis.

This paper presents a brief review of the literature regarding congenital distichiasis. The literature is confusing regarding the term distichiasis. Distichiasis should be utilized to describe congenital partial or complete accessory rows of eyelashes which exit from the posterior lid margin behind the meibomian gland orifices. The term acquired trichiasis and congenital distichiasis are significantly different. This paper also describes a new method for microscopically dissecting and excising the follicles of distichiatic eyelashes. The technical details of the surgical procedure are described with appropriate illustrations. This procedure can also be utilized for removal of localized areas of acquired trichiasis. The advantage of this procedure over previously utilized procedures for congenital distichiasis is the lower incidence of recurrent distichiatic lashes, combined with complete preservation of normal eyelashes and essentially no risk of cicatricial entropion following this procedure.