Objective: To compare the efficacy of subcutaneous extralesional triamcinolone acetonide injection versus conservative treatment for chalazion.
Design: Randomised controlled trial.
Setting: Eye clinics of two regional hospitals in Hong Kong.
Patients: Patients over 18 years old presenting with primary chalazion were randomised into two groups. In group 1, 12 patients were treated with lid hygiene, warm compresses, and chloramphenicol 1% ointment 4 times a day. In group 2, 16 patients were treated with 0.3 mL triamcinolone acetonide (10 mg/mL) injection to the subcutaneous tissue extralesionally via the percutaneous route. Exclusion criteria were: acutely infected chalazion with preseptal cellulitis, recurrent chalazion, small chalazion (< or =2 mm), and prior treatment to chalazion.
Main outcome measures: Size of chalazion, recurrence of chalazion, intra-ocular pressure, and complications from treatment, including skin pigmentary change or atrophy and pyogenic granuloma.
Results: There was a clinically and statistically significant difference between the success rates in group 1 (58.3%) and group 2 (93.8%). In group 1, the mean prior duration of chalazion before treatment was significantly shorter in success cases than in failed cases. One patient with multiple chalazia in group 2 developed hypopigmentary skin changes at one treatment site.
Conclusion: Subcutaneous extralesional triamcinolone acetonide injection was more effective than conservative treatment for chalazion.