Treatment of distichiasis with cryotherapy

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.