Intralesional triamcinolone acetonide injection for primary and recurrent chalazia: is it really effective?
OBJECTIVE
To evaluate the safety and efficacy of intralesional triamcinolone acetonide (TA) injection in primary and recurrent chalazia.


METHODS
Retrospective, interventional, consecutive case series.


METHODS
One hundred forty-seven patients with primary or recurrent chalazia (155 cases) treated at the oculoplastic clinic at the Jules Stein Eye Institute between January 1, 2000, and December 31, 2003.


METHODS
Patients received an intralesional injection of 0.1 to 0.2 ml TA (40 mg/ml). Data regarding lesion size, including digital color photography, lesion regression or recurrence, and complete ophthalmic examination, were recorded at the time of injection and at different intervals until resolution or surgical excision. Success was defined as at least an 80% decrease in size with no recurrence. If the lesion recurred or regression was minimal (<50%), further injections were given as needed. Patients who declined injection or who did not respond to 2 to 3 injections were referred for surgical excision and drainage.


METHODS
Lesion size, clinical resolution, time to resolution, recurrence, and complications.


RESULTS
Most of the patients received 1 injection (93 patients; 60%) or 2 injections (31 patients; 20%) with resolution of the lesion (more than 80% decrease in size), with an average time to resolution of 2.5 weeks. Patients who did not respond to 2 injections were more likely to fail treatment (minimal or no regression), to respond to further injections, or to undergo surgical excision and drainage (P = 0.0001, chi-square test). Patients with blepharitis required more injections to resolution (2+/-1.3 vs. 1.4+/-1; P = 0.05, independent samples t test). Intraocular pressure and visual acuity remained stable after treatment. No complications, such as visual loss, subcutaneous fat atrophy, or skin depigmentation changes, were noted with steroids injections; assuming a complication rate of 2%, our power was adequate to rule out these complications.


CONCLUSIONS
Intralesional TA injection in primary and recurrent chalazia is effective in achieving lesion regression. Most cases resolve with an average of 1 to 2 injections. Chalazia that fail to respond to 2 or 3 injections are more likely to benefit from surgical excision. It may be considered as a first treatment in cases where diagnosis is straightforward.
Ben Simon
Guy J
GJ
Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. simon@jsei.ucla.edu
Huang
Lynn
L
Nakra
Tanuj
T
Schwarcz
Robert M
RM
McCann
John D
JD
Goldberg
Robert A
RA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017043:Chalazion / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D002648:Child; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide