Lid Splitting and Posterior Lamellar Cryotherapy for Congenital Distichiasis and Trichiasis in Dog

Various surgical techniques have been proposed for treating distichiasis in dogs. A technique involving eyelid splitting and double freeze-thaw cryotherapy with anterior lamellar recession was evaluated. A 3 year old, female, Staffordshire bull terrier was referred for bilateral distichiasis. There were bilateral multiple distichiasis of the upper lids, more severe on the right lid with double row of cilia and two cilia on the lower lid. Under general anaesthesia, the eyelid margin was split at the gray line and a cryoprobe was used to freeze the posterior lamella. A double freeze-thaw technique was applied in both eyes. Anterior lamellar recession was performed to prevent postoperative entropion with trichiasis. The anterior and posterior lamellas were sutured with a 6/0 Vicryl suture. Bilateral upper eyelid edema was noted postoperatively. A month follow-up revealed increased bilateral granulation and depigmentation and the recurrence of one follicle on the right upper lid. Five months postoperatively there was no recurrence in the left eye but three cilia were detected in the right upper lid. The follicles have regrown due to incomplete destruction of the roots. Lid margin split with cryotherapy is an effective method for treating distichiasis but might require several attempts and increase in the cryotherapy time.