Modified treatment of distichiasis with direct tarsal strip excision without mucosal graft

Purpose: To describe a new modified technique of direct tarsal excision for treatment of distichiasis. Methods: Retrospective review of consecutive patients who underwent direct tarsal excision without grafting to treat distichiasis between December 2007 and November 2015. Gender, number of eyelids treated, follow-up time, and surgical outcome were recorded. The technique involved dividing the anterior and posterior lamella and excising a two mm tarsoconjunctival strip including the abnormal lash follicles, without suturing or mucosal graft. Results: Seventeen eyelids of 12 patients (Fourteen upper eyelids and 3 lower eyelids) were studied. Sixteen eyelids had acquired distichiasis and one eyelid had congenital distichiasis. Mean age was 64.8 (SD 22.0; range, 25–86 years) Mean postoperative follow-up time was 53 months (SD = 31, range 8–104 months). During this period, no recurrence was documented. There were no complications. Conclusions: Direct tarsal excision without a graft is a safe, quick, and effective method for the treatment of distichiasis.