How often does a chalazion require surgical intervention?

From the Research

Surgery for a chalazion is typically only required in about 25-30% of cases, as most chalazia resolve on their own or with conservative treatment within 1-2 months.

Treatment Overview

When considering treatment options, it's essential to weigh the benefits and risks of each approach.

• Conservative measures like warm compresses (applied for 10-15 minutes, 4 times daily for 1-2 weeks), lid massage, and good eyelid hygiene are often the first line of treatment.
• Medical treatment may include antibiotic-steroid combination eye drops or ointments such as tobramycin/dexamethasone applied 2-4 times daily for 7-10 days.
• For larger or persistent chalazia, a doctor might consider an intralesional steroid injection (triamcinolone acetonide 2-4 mg) before resorting to surgery, as seen in the study by 1.

Surgical Intervention

Surgery becomes necessary when a chalazion persists despite conservative measures.

• The surgical procedure, called incision and curettage, is minor and performed under local anesthesia, typically taking only 15-20 minutes.
• Surgery is more likely to be recommended for chalazia that are large, painful, affect vision, or have been present for more than 2 months.
• The need for surgery increases in recurrent cases or when there's concern about possible malignancy, particularly in older adults with unilateral, non-healing lesions.

Comparison of Treatment Options

A study by 1 compared the outcomes of intralesional triamcinolone acetonide injection and incision and curettage in the treatment of chronic chalazion, finding that both methods are effective, but incision and curettage had a higher success rate and less recurrence.

Recommendations

Incision and curettage is recommended for patients with large, painful, or recurrent chalazia, or when there's concern about possible malignancy. Intralesional steroid injection can be considered as an alternative treatment option, especially for patients who are not good candidates for surgery or prefer a less invasive approach, as supported by the study by 1.