Thermal cautery after chalazion surgery and its effect on recurrence rates

Chalazion surgery is a common minor surgical procedure used to treat internal chalazia after conservative measures have failed. Complications are infrequent and generally easily managed with minimal problems. In this clinical research study, 100 internal chalazia surgical candidates were randomly divided into two treatment groups. Our initial goal was to ascertain whether cautery impacted the recurrence rates on chalazia in these patients. One group received thermal cautery after surgical incision and drainage. The second group did not receive cautery after incision and drainage. Lack of cautery caused no problems with hemostasis because bleeding resolved without incident after several additional minutes.

The study was conducted on 100 patients who received 4 weeks of conservative treatment consisting of alternating warm and cold compresses and topical prednisolone acetate/sulfa medication (e.g., blephamide) administered 4 times a day. A transconjunctival incision and drainage was performed, followed by thermal cautery in one-half (N = 50) of the randomized patients.

The cauterized group had a 78% no recurrence rate after 6 months and good surgical outcomes. The remaining 22% had a recurrence of chalazia, but with good initial surgical outcome. The noncauterized group (N = 50) showed a 74% no recurrence rate after 6 months and good surgical outcome. The remaining 26% had recurrences with good initial surgical outcomes. A chi-square test indicated that there was no significant statistical difference between the groups (chi2 = 0.219, dF = 1.0, p = 0.640).

The results of this clinical study suggest that the use of thermal cautery with surgery has no impact on the recurrence rate of internal chalazia. Thus, the use of thermal cautery should be left to the discretion of the eye care practitioner.