Intralesional triamcinolone acetonide injection versus incision and curettage for primary chalazia: a prospective, randomized study.

Author(s): Ben Simon GJ, Rosen N, Rosner M, Spierer A

Affiliation(s): Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel. guybensimon@gmail.com

Publication date & source: 2011-04, Am J Ophthalmol., 151(4):714-718.e1. Epub 2011 Jan 22.

Publication type: Comparative Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

PURPOSE: To compare treatment outcomes of intralesional triamcinolone acetonide (TA) injection with incision and curettage (I&C) for primary chalazia. DESIGN: Prospective, randomized clinical trial. METHODS: SETTING: Institutional. STUDY POPULATION: Ninety-four patients with primary chalazia after failed conservative treatment were randomized to either intralesional TA injection (4 mg) or I&C performed under local anesthesia. All patients underwent comprehensive eye examinations that included digital photography of the lesion. Complete resolution was defined as lesion regression of 95% to 100%. Treatment was considered a failure if no resolution was achieved after the first attempted I&C or TA injection. MAIN OUTCOME MEASURES: Lesion resolution measured as 95% to 100% regression. RESULTS: Ninety-four patients participated in the study: 42 underwent I&C and 52 underwent TA injection as the first treatment. Complete resolution was achieved in 33 (79%) of 42 patients in the I&C group and in 42 (81%) of 52 patients in the TA group (P=.8, chi-square analysis). The average time to resolution in the TA group was 5 days, with most patients (48/52; 92%) having received a single injection and 4 (8%) of 52 patients having received 2 injections. TA precipitates were detected in 6 (11.5%) of 52 patients and resolved spontaneously. There were no complications, such as eyelid depigmentation, increased intraocular pressure, or any loss of vision, in either group. CONCLUSIONS: Intralesional TA injection is as effective as I&C in primary chalazia. Injection may be considered as an alternative first-line treatment in cases where diagnosis is straightforward and no biopsy is required. Copyright (c) 2011 Elsevier Inc. All rights reserved.