Three methods of treatment of Chalazia in children

OBJECTIVE: This is a pilot prospective study undertaken to compare 3 methods of chalazion treatment, namely intralesional triamcinolone acetonide injection, incision and curettage and the combination of incision, curettage and intralesional triamcinolone acetonide injection.

METHODS: Twenty-six pediatric age patients with 36 chalazia were divided into 3 groups of 12 chalazia each. The first group received intralesional triamcinolone acetonide 5 mg/ml injection, the 2nd group was treated by simple incision and curettage and the 3rd group was treated by incision, curettage and intralesional triamcinolone acetonide injection on the same session.

RESULTS: In the first group, after 2 weeks from receiving intralesional suspension of triamcinolone acetonide injection, 9/12 (75%) of the chalazia had resolved. Two chalazia resolved after 2 weeks from the 2nd injection and one resolved after a 3rd injection. In spite of improvement, 3 patients complained of either recurrence or development of new adjacent lesions. Two patients had yellow deposits at the site of transcutaneous injections. In the 2nd group, 9/12 (75%) lesions resolved after the first surgery, and the other 3 lesions responded to repeated surgery. Recurrence or appearance of new lesions adjacent to the old one was noticed in 2 cases after approximately one month from resolution. In the 3rd group, resolution was found in all patients 12/12 (100%) after 2 weeks, and neither recurrence nor complications were faced.

CONCLUSION: The 3 procedures were safe, effective and convenient. Intralesional corticosteroid injection is a good procedure for children, patients with allergy to local anesthesia, chalazia close to the lacrimal drainage system and it is convenient for physicians other than ophthalmologists. Incision and curettage is recommended for patients with infected chalazia. Combined incision, curettage and intralesional corticosteroid injection is more convenient for patients with large, recurrent and multiple chalazia.