Surgical management of canine distichia.
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A simplified cryotherapy technique for the treatment of trichiasis and distichiasis is described. The success rate of aberrant lash ablation with one treatment was 82%; this was increased to 95% with a repeat treatment. There have been minimal long-term side effects. This paper shows that a simplified time-based technique without the use of a thermocouple has produced results similar to other series using thermocouple control. A nitrous oxide cryo unit was used in a double freeze-thaw cycle to treat the area of aberrant lash growth. The times in the double freeze-thaw cycle found to be effective were 45 seconds freezing with a four-minute thaw in the first cycle and a repeat freezing cycle of 45 seconds' duration.
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The use of chondromucosal grafts is the classical treatment for reconstruction of the eyelids, whereas these grafts are less employed for correction of tarso-conjunctival scars due to either disease or surgery. The ideal nasal graft is the triangular cartilage, as its mucosa is more delicate and more adhesive than that of the septum, and it separation and positioning do not involve any problems if certain rules are followed. The technique appears attractive to us, as it is simple to perform, there is a lack of postoperative complications and it is logical (replacing a pathological tissue or a missing tissue by an identical one, keeping the lids framework). It appears to be not enough employed in trachomatous entropion (both eyelids being generally affected). However, the technique is useful: during first intention surgery (whether associated or not with tarsectomy); in all cases of recurrence, where it appears to be the only worthwhile treatment (trachomatous eyelids already operated upon by another method, tarsectomy alone).
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A 30-year-old women suffered from right superior eyelid infestation of Ixodes ovatus Neumann, which was mechanically removed with forceps after application of benzine. No mouth parts were retained in the eyelid. Removed mouth parts were examined by a scanning electron microscope. There were no complications except focal trichotylosis in the involved area. The mode of attachment of the tick to the host and the method of removal were discussed.
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The surgical treatment of distichiasis has frequently resulted in disfigurement of the treated eyelid. Since the follicles of the aberrant lashes in lids with distichiasis are placed more posteriorly than the follicles of normal lashes, it is theoretically possible to destroy the follicles of the aberrant lashes without destroying the follicles of the normally placed lashes if transconjunctival cooling creates a sufficient temperature gradient from the conjunctival to the anterior tarsal surface. This report illustrates a successful application of this concept. However, further data are needed to delineate the optimum cryo treatment of distichiasis.
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