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To the Editor.—The article "Surgical Repair for Distichiasis, Trichiasis, and Entropion" by William Fein that appeared in the Archives (94:809-810, 1976) suggests that a lid splitting with manipulation of the base of the lashes in the anterior lamella followed by an anterior lamella recession surgically corrects distichiasis, cicatricial entropion, and trichiasis. This is an excellent procedure for trichiasis, which is misdirected lashes of the anterior lamella. However, the procedure should have no beneficial effect in distichiasis, which is an accessory row of abnormal lashes in the tarsal portion of the eyelid that occupies the site of the meibomian glands. A posterior lamella operation is required to correct distichiasis.
The term distichiasis is generally reserved for those congenital cases of an abnormal accessory row of lashes stemming from the meibomian gland orifices. While it requires a bastardization of the term, I find "aquired distichiasis" to be more useful to describe
Anderson RL. Surgical Repair for Distichiasis. Arch Ophthalmol. 1977;95(1):169. doi:10.1001/archopht.1977.04450010169026