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Conservative therapy for chalazia: is it really effective?
Albert Y Wu1,2,3, Kalla A Gervasio1,2,4, Kellie N Gergoudis1,2
1Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Acta Ophthalmologica
|January 17, 2018
Summary
Hot compresses (HC) alone or with tobramycin or tobramycin/dexamethasone are effective first-line chalazia treatments. Consider invasive therapies for chalazia present longer than two months, as older lesions resolve less often with conservative care.
Area of Science:
- Ophthalmology
- Ophthalmic Surgery
- Clinical Medicine
Background:
- Chalazia are common eyelid lumps that can cause discomfort and visual disturbance.
- Conservative management, including hot compresses, is often the first approach.
- The efficacy of adding antibiotics or corticosteroids to hot compresses for chalazia treatment requires further investigation.
Purpose of the Study:
- To compare the effectiveness of hot compresses (HC) alone versus HC combined with tobramycin or tobramycin/dexamethasone for treating chalazia.
- To evaluate the impact of these treatments on chalazion size, pain, and patient satisfaction.
Main Methods:
- A multicenter, randomized clinical trial involving 149 patients with chalazia.
- Patients were assigned to receive either HC, HC plus tobramycin, or HC plus tobramycin/dexamethasone for 4-6 weeks.
- Outcomes included complete resolution rate, reduction in chalazion width, and patient-reported pain and satisfaction.
Main Results:
- No significant difference in complete chalazion resolution was observed between the three treatment groups (p=0.78).
- All treatment groups showed statistically significant reductions in chalazion size (p<0.001).
- Chalazia present for a shorter duration (1.5 months) were more likely to completely resolve than those present for longer (2.2 months, p=0.04).
Conclusions:
- Hot compresses, with or without tobramycin or tobramycin/dexamethasone, are effective first-line treatments for chalazia.
- For chalazia present for over two months, more invasive treatments like incision and curettage or steroid injections may be more appropriate due to lower resolution rates with conservative therapies.
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