Aim To describe a surgical procedure for excising the eyelash line to treat cilial entropion in patients with Down's syndrome.

Methods 24 Down's patients with cilial entropion and medial epiblepharon underwent eyelash line resection bilaterally. The area and density of fluorescein staining of the superficial punctate keratopathy (SPK; 0=none to 3=wide or severe) and the frequency of spectacle wear (0=no wear to 2=all day wear) were evaluated prospectively.

Results The postoperative area and density of the SPK improved significantly in both eyes (p<0.001, p<0.001). The score of spectacle wear was 1.3±0.8 preoperatively which improved significantly to 1.7±0.5 after surgery (p=0.018). Five patients had a partial recurrence of misdirected eyelashes adjacent to the site of the excision. Two patients had extended excisions of the misdirected eyelashes 3 years after the initial surgery, and they did not have any further recurrences. Three other patients were followed without additional treatment because lacrimation and eye discharge were mild even with some eyelashes misdirected toward cornea.

Conclusions Eyelash line resection is a simple and effective technique for cilial entropion and medial epiblepharon in patients with Down's syndrome. The surgery improves the SPK and frequency of spectacle wear.

Trial registration number NCT01758718.