Orbit

The International Journal on Orbital Disorders, Oculoplastic and

Lacrimal Surgery

ISSN: 0167-6830 (Print) 1744-5108 (Online) Journal homepage: https://www.tandfonline.com/loi/iorb20

Chalazion Treatment

Mehmet Unal

To cite this article: Mehmet Unal (2008) Chalazion Treatment, Orbit, 27:6, 397-398, DOI:
10.1080/01676830802623174

To link to this article: https://doi.org/10.1080/01676830802623174

Published online: 08 Jul 2009.

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Orbit, 27:397–398, 2008
Copyright

c 2008 Informa Healthcare USA, Inc.
ISSN: 0167-6830 print / 1744-5108 online
DOI: 10.1080/01676830802623174

EDITORIAL

Chalazion Treatment
Mehmet Unal, MD Chalazion is a chronic lipogranulomatous inflammation of the meibomian
Gazi University Medical School, or Zeis glands, caused by cystic retention of material in the sebaceous glands. It
Ankara, Turkey
is one of the commonest eyelid disorders of all age groups, and usually, presents
with inflammation and irritation of the eyelid and ocular surface. Although it
may be a self-limited disease, its management can be difficult for both the oph-
thalmologists and the patients, due to its high recurrence rate and chronicity.
The treatment modalities include eyelid hygiene with hot compresses, topi-
cal antibiotic ointment, and systemic tetracycline in cases with acne rosacea.
However, most lesions usually necessitate more invasive procedures like steroid
injections or incision and curettage surgery.
Localized steroid injections are given in the form of Kenakort-A (triamci-
nolone acetonide 0.1–0.2 ml of 40 mg/ml) suspension. The injection is per-
formed directly into the lesion via a conjunctival approach. Antibiotic ointment
is applied and the eye is not patched after the injection.
The classical therapeutic approach in, chalazion is the incision and curettage
surgery. I prefer to use a scalpel blade for incision and curettage of chalazion.
In this technique, local anesthetic (2% lidocaine with 1:100,000 epinephrine)
is infiltrated around the chalazion. A chalazion clamp is placed over the lesion
and the eyelid is everted. The clamp is tightened. A scalpel blade is used to make
first a vertical incision into the tarsus. Then a horizontal incision is performed to
complete a cross shaped incision into the chalazion, A chalazion curette is used
to scrape out the contents of the cyst. The fibrous capsule around the chalazion
is excised with scissors. The clamp is slowly loosened and any bleeding points
are cauterized. Antibiotic ointment is applied and the eye is patched.
Ben Simon et al. (2005) performed intralesional triamcinolone injections in
155 cases. They concluded that this treatment was effective in lesion regression
in most cases with 1 or 2 injections. They reported that chalazia which did not re-
spond to 2 or 3 injections were more likely to benefit from incision and curettage
surgery. Goawalla and Lee’s (2007) prospective randomized study compared the
effectiveness of hot compresses, steroid injections and surgical curettage in 136
patients. They reported that steroid injections and incision and drainage surgery
had comparable results, and gave better results than conservative treatment with
hot compresses.
Although more predictable results are achieved with incision and curettage
surgery, there are few shortcomings of this approach. First, some patients dislike
the idea of undergoing surgery and prefer injections to surgery. Second, the
surgery usually necessitates standard equipments and sterility conditions that
make it more expensive than its alternatives. Third, many surgeons prefer patch-
ing the eye for 24 hours, which make surgery a less favorable option, especially

397
in younger patients who have concerns with their time and recurrent chalazia: is it really effective? Ophthalmology 2005;
112:913–917.
loss of working hours, as well as their cosmesis.
Goawalla A, Lee V. A prospective randomized treatment study compar-
ing three treatment options for chalazia: triamcinolone acetonide
REFERENCES injections, incision and curettage and treatment with hot com-
Ben Simon GJ, Huang L, Nakra T, Schwarcz RM, McCann JD, Gold- presses. Clinical and Experimental Ophthalmology 2007; 35:706–
berg RA. Intralesional triamcinolone acetonide injection for primary 712.

M. Unal 398