Intralesional corticosteroid injection vs surgical treatment of chalazia in pigmented patients

To compare the outcome of intralesional corticosteroid injection and surgical treatment of chalazia. An interventional comparative study. PNS Shifa, Naval Hospital, Karachi from 1st September 2002 to 31st August 2003. During a 9-month recruitment period all patients attending PNS Shifa, Naval Hospital, Karachi, for treatment of chalazia were inducted in the study. A 141 patients with chalazia completed the study. Patients received either incision-curettage [surgical treatment/ ST group] or intralesional corticosteroid injection treatment [steroid injection/ SI group]. The same procedure was repeated in unsuccessful cases only once. Z-test of proportion was used as appropriate statistical test of significance at p <0.05 for the comparison of the results between the two groups. The success was achieved in 59 out of 75 patients [79%] in ST group and 41 of 66 patients [62%] in SI group at first visit after two weeks [p-value <0.01]. The success in ST group improved to 89% [67 out of 75 patients] after second operation and to 80% [53 out of 66 patients] in SI group after second injection of the steroid given at second week [p-value < 0.14]. Intralesional steroid injection is an effective and safe alternative procedure for the treatment of chalazia. The results are comparable to surgical treatment especially after second injection. It is not associated with any serious complications although skin depigmentation is relatively common in coloured population

Subconjunctival total excision in the treatment of chronic chalazia.

A technique of subconjunctival total excision was used to treat 34 chronic chalazia. Another 34 were treated by incision and curettage and a further 32 by intralesional injection of long acting steroid. Subconjunctival total excision showed a higher success rate (94.12%) compared to the incision and curettage group (76.47%) and the injection group (75%). As the difference was statistically significant and due to other advantages we recommend subconjunctival total excision as a primary approach in the treatment of chronic chalazia.