Canine distichiasis results in chronic irritation and ulcerative keratitis. Recognition and treatment of disease are key to helping distichiasis patients avoid corneal ulceration and chronic pain.

This retrospective study evaluated records of 26 dogs (50 eyes, 88 eyelids) that had undergone transconjunctival thermal electrocautery (TCEC) treatment for distichiasis. Long-term follow-up (range, 13-702 days) showed 96% of the eyes to have been effectively treated (ie, clinical signs attributable to distichiasis were resolved). During follow-up, 69% of eyelids were free of distichiae and 25% were determined to have recurrent distichiae; however, it was unknown whether these hairs were growing from treated or adjacent untreated follicles. The remaining 6% developed new distichiae.

Noted complications included transient eyelid pigment loss, mild-to-moderate eyelid swelling, treatment site infection, and qualitative tear film deficiency and were reported to be similar to complications noted with other surgical techniques used for treating distichiasis. Although corneal ulceration was not observed in this study, the authors cautioned that corneal ulceration can occur if charred conjunctival tissue is not irrigated at the end of the procedure.

The authors concluded that TCEC is a technically simple, quick, and noninvasive procedure that can be performed with commonly used ophthalmic instruments and other available tools. 

Key pearls to put into practice:

TCEC is a novel surgical approach for the elimination and control of canine distichiae and is less destructive and more cost-efficient than other surgical procedures. TCEC is highly effective, has minimal complications, and can be performed using general anesthesia, proper magnification, a Desmarres Chalazion clamp, a battery-powered thermal cautery unit, postoperative pain control, and postoperative antibiotics.

Although TCEC is generally a low-risk procedure, clinicians should be aware of proper technique and potential complications. Caution should be used so the thermal cautery unit does not penetrate too far into the eyelid margin or touch the corneal surface.

Pet owners should be educated about the potential complications of TCEC (eg, entropion, eyelid pigment loss, eyelid swelling, treatment site infection, recurrence of distichiae, qualitative tear film deficiency).