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

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.

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.