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In Reply.—Dr Anderson's comments indicate that I did not sufficiently clarify the potential of this surgical technique. There appears to be no difficulty in appreciating the efficacy of this method in repairing lash problems due to disease of the anterior lamella. The posterior lamella, however, is also accessible through this incision. If the offending lashes originate in the meibomian glands of the tarsel plate, direct visualization enables the surgeon to currette, excise, or electroepilate these hairs at their bases. As is shown in Fig 3 of the article, the lid-splitting incision allows inspection of and access to the bases of the lashes whether they originate in the anterior or the posterior lamella.
Inversion of lashes due to epiblepharon also can be treated by this technique, if the congenital problem does not resolve spontaneously.
Fein W. Surgical Repair for Distichiasis-Reply. Arch Ophthalmol. 1977;95(1):169. doi:10.1001/archopht.1977.04450010169027