A prospective randomized treatment study comparing three treatment options for chalazia: triamcinolone acetonide injections, incision and curettage and treatment with hot compresses.

BACKGROUND: Three methods of treating chalazia were compared: intralesional triamcinolone acetonide injections (0.2 mL of 10 mg/mL), incision and curettage and advice regarding the application of hot compresses to the affected eyelid.

METHODS: This was a single centre randomized treatment study. Patients with a chalazion underwent either of the three treatment options. Chalazion resolution, pain, satisfaction and inconvenience experienced because of treatments were the outcomes assessed via a telephone interview at 3 weeks.

RESULTS: 136 consecutive patients were enrolled into the study. At the 3-week follow up, the resolution rates in the triamcinolone acetonide injection and surgical treatment groups were not significantly different from each other at 84% (47/56) and 87% (39/45), respectively (P < 0.001), but was significantly lower in the conservative treatment group at 46% (16/35) (P < 0.001). Pain scores were higher in the surgical treatment group compared with the triamcinolone injection group (P < 0.003). Inconvenience experienced by patients was reported as significantly less in the triamcinolone group compared with the conservative and surgical treatment groups (P < 0.001). Patient satisfaction scores were lower in the conservative treatment group compared with each of the other two groups which in turn, were no different from each other regarding this outcome (P < 0.001).

CONCLUSIONS: To our knowledge, this is the first prospective randomized study comparing the three methods of chalazia treatment. Results suggest that a single triamcinolone acetonide injection followed by lid massage is almost as effective as incision and curettage in the treatment of chalazia and with similar patient satisfaction and less pain and patient inconvenience.