[Treatment of trichiasis and distichiasis with a biopsy punch -- an effective and practical method for eyelash...

Localised distichiasis and trichiasis with resulting keratopathy leads to considerable impairment for the patient. We present a new technique which enables the surgeon to excise the lash with its follicle to prevent regrowth in a single movement. The procedure does not need any preparation, leaving the lid with minimal concomitant trauma which prevents recurrence of trichiasis. The excision is done with a dermatological biopsy punch (Kai Europe GmbH, Solingen, Germany). The punch is placed on the appropriate place perpendicular to the lid margin where the punch is driven 3-4 mm parallel to the lash. Histopathological diagnosis should be obtained not only to prove the principle of this technique: the entire biopsy material should be handed over to the pathologist as distichiasis and trichiasis can be the first sign of lid tumours. The presented technique of hair follicle excision with a biopsy punch is extremely effective. Success can be proven by the results of histological work-up of the biopsy material.