Incision and Curettage Versus Steroid Injection for the Treatment of Chalazia: A Meta-Analysis

Aycinena, Alicia R. P.; Achiron, Asaf; Paul, Michael A.; Burgansky-Eliash, Zvia

doi:10.1097/iop.0000000000000483

Cited by 27 publications

(17 citation statements)

References 12 publications

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“…Previous studies reported 50–95% success rates for steroid injections 3, 6. Ben Simon and colleagues' studies showed intralesional TA injection was as effective as I&C in primary chalazia 4, 11.…”

Section: Discussionmentioning

confidence: 99%

“…In the acute phase, conservative therapy includes warm compresses and antibiotic or corticosteroid ointments. Previous studies have reported a 25–50% resolution rate for these conservative methods 5, 6, 7. Two standard treatment methods for chalazion are intralesional triamcinolone acetonide (TA) injections and incision and curettage (I&C).…”

Section: Introductionmentioning

confidence: 99%

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A prospective randomized study comparing incision and curettage with injection of triamcinolone acetonide for chronic chalazia

Nabie

Soleimani

Nikniaz

et al. 2019

Journal of Current Ophthalmology

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PurposeTo compare outcomes of intralesional triamcinolone acetonide (TA) injection and incision and curettage (I&C) in the treatment of chronic chalazion.MethodsPatients with chronic chalazion were randomized in two groups. The patients in the TA received an intralesional injection of TA and patients in the I&C underwent I&C. The patients were followed up 3, 7, 14, 21, 28, and 45 days after the procedures. We defined success as 90% regression in the size of the lesion.ResultsThere were 26 patients in the TA and 25 patients in the I&C enrolled in this study. Complete resolution was achieved in 16 patients (61.5%) in the TA group and 21 patients (84%) in the I&C (P = 0.072). Sex, initial size, and chalazion location did not influence treatment success in either group (P > 0.05). Lesion recurrence occurred in 9 patients (34.61%) in the TA group and 2 (8%) in the I&C (P = 0.04). The average times to resolution were 8.8 ± 5.6 and 5.1 ± 4.5 days in the first and second groups, respectively (P = 0.03). Drug deposition occurred in 24 (92.3%) patients in the TA group, and ecchymosis occurred in 14 (56%) patients in the I&C (P = 0.004) group. Intraocular pressure (IOP) in the TA group and visual acuity (VA) in both groups remained unchanged.ConclusionsBoth TA injection and I&C modalities are effective in the treatment of chronic chalazia. Advantages of I&C in comparison to TA include less recurrence, shorter duration of complications, and a higher success rate.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A prospective randomized study comparing incision and curettage with injection of triamcinolone acetonide for chronic chalazia

Nabie

Soleimani

Nikniaz

et al. 2019

Journal of Current Ophthalmology

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“…A 2016 meta-analysis compared steroid injection with I&C and concluded that the surgical intervention was more effective after one procedure (60% vs 78%) with a decrease in relative efficacy if taking into account a second attempt (73% vs 87%); there were no differences in complication rates between the two procedures 4. Singhania et al noted that the resolution of medium to large size chalazia (chalazia diagnosis was confirmed by biopsy) was comparable between one steroid injection (90% for medium and 74% for large) and I&C (92% for medium and 91% for large) taking an average of 2–3 weeks to resolve; the reason for the better results in the steroid group may be attributed to removal of material within the lesion for biopsy before steroid injection 19.…”

Section: Discussionmentioning

confidence: 99%

“…The most invasive treatment is the I&C surgical procedure. It has been demonstrated to be more effective than steroid injection alone after one treatment 4. It is generally effective but can result in lid notching if the lid margin is involved, or eyelid perforation with resultant scarring and hemorrhaging.…”

Section: Introductionmentioning

confidence: 99%

<p>Low level light therapy for the treatment of recalcitrant chalazia: a sample case summary</p>

Stonecipher¹,

Potvin²

2019

OPTH

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PurposeTo evaluate the effects of low-level light therapy (LLLT) on the resolution of recalcitrant chalazia.Patients and MethodsThis was a single-site retrospective chart review of patients with chalazia, all of whom were unresponsive to previous pharmaceutical therapy or surgical intervention, who received a 15 min LLLT treatment in conjunction with a standard pharmaceutical regimen. A second treatment was applied 24 hrs to as late as 2 months if there was no evidence of progression of resolution in appearance.ResultsA total of 26 eyes of 22 patients with relevant history and treatment were reviewed, all with a history of prior pharmaceutical treatment for their chalazia. After a single 15 min LLLT treatment, followed by a standard pharmaceutical regimen, 46% of eyes (12/26) showed resolution of their chalazia. Resolution was noted from 3 days to one-month post-treatment. With a second treatment, the chalazia resolved in 92% of eyes (24/26). Only two eyes of the 26 (8%) required incision and curettage after LLLT treatment.ConclusionThe use of LLLT for the treatment of recalcitrant chalazia appears to be beneficial in patients who have failed topical and/or systemic therapy, significantly reducing the likelihood of requiring surgical intervention.

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“…Single series studies with small patient numbers (n = 42-129) indicate failure rates of 13%, 28% and 21% [1], [2], [3]. Meta-Analysis study (264 patients) gives a failure rate of 22% [4]. These failure rates in the literature relate to procedures in which a single incision was undertaken.…”

Section: Introductionmentioning

confidence: 99%

Surgical Management with Particular Reference to Failure Rate in a Case Series of 1498 Consecutive Cases of Chalazion Incision and Curettage by a Single Practitioner

Cook¹

2018

CTOY

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A series of 1498 consecutive vertical incisions of chalazia was studied by the author to examine the spectrum of epidemiological presentation of chalazia for a population, the failure rate for incision and curettage and how each failure was managed. The number of incisions made in each chalazion was also examined as the author had developed an impression over the years that a better success rate was achieved with more than one incision. Using 3 vertical incisions, the 7.6% failure rate is considerably lower than previous studies in the literature in which only one incision was undertaken. This case series also supports a practical pragmatic approach as to how to manage failure of incision and curettage and questions the need for routine diagnostic biopsy to exclude ocular sebaceous cell carcinoma after first failure in incision and curettage.

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Incision and Curettage Versus Steroid Injection for the Treatment of Chalazia: A Meta-Analysis

Abstract: This analysis shows that I&C is more effective than SI with 1 procedure. This benefit is reduced when comparing 1 or 2 attempts of I&C and SI. Studies failed to show a difference in the incidence of complications with either procedure.

Cited by 27 publications

References 12 publications

A prospective randomized study comparing incision and curettage with injection of triamcinolone acetonide for chronic chalazia

A prospective randomized study comparing incision and curettage with injection of triamcinolone acetonide for chronic chalazia

<p>Low level light therapy for the treatment of recalcitrant chalazia: a sample case summary</p>

Surgical Management with Particular Reference to Failure Rate in a Case Series of 1498 Consecutive Cases of Chalazion Incision and Curettage by a Single Practitioner

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