Mustafa T A, Oriafage I H
Opthalmology Clinic, Prince Rashid Bin Al-Hasan Military Hospital, Royal Medical Services of Armed Forces, Irbid, Jordan.
Saudi Med J. 2001 Nov;22(11):968-72.
This is a pilot prospective study undertaken to compare 3 methods of chalazion treatment, namely intralesional triamcinolone acetonide injection, incision and curettage and the combination of incision, curettage and intralesional triamcinolone acetonide injection.
Twenty-six pediatric age patients with 36 chalazia were divided into 3 groups of 12 chalazia each. The first group received intralesional triamcinolone acetonide 5 mg/ml injection, the 2nd group was treated by simple incision and curettage and the 3rd group was treated by incision, curettage and intralesional triamcinolone acetonide injection on the same session.
In the first group, after 2 weeks from receiving intralesional suspension of triamcinolone acetonide injection, 9/12 (75%) of the chalazia had resolved. Two chalazia resolved after 2 weeks from the 2nd injection and one resolved after a 3rd injection. In spite of improvement, 3 patients complained of either recurrence or development of new adjacent lesions. Two patients had yellow deposits at the site of transcutaneous injections. In the 2nd group, 9/12 (75%) lesions resolved after the first surgery, and the other 3 lesions responded to repeated surgery. Recurrence or appearance of new lesions adjacent to the old one was noticed in 2 cases after approximately one month from resolution. In the 3rd group, resolution was found in all patients 12/12 (100%) after 2 weeks, and neither recurrence nor complications were faced.
The 3 procedures were safe, effective and convenient. Intralesional corticosteroid injection is a good procedure for children, patients with allergy to local anesthesia, chalazia close to the lacrimal drainage system and it is convenient for physicians other than ophthalmologists. Incision and curettage is recommended for patients with infected chalazia. Combined incision, curettage and intralesional corticosteroid injection is more convenient for patients with large, recurrent and multiple chalazia.
本前瞻性试验研究旨在比较睑板腺囊肿的三种治疗方法，即病灶内注射曲安奈德、切开刮除术以及切开刮除术联合病灶内注射曲安奈德。
26例患有36个睑板腺囊肿的儿童患者被分为3组，每组12个睑板腺囊肿。第一组接受5mg/ml曲安奈德病灶内注射，第二组采用单纯切开刮除术治疗，第三组在同一疗程中采用切开刮除术联合病灶内注射曲安奈德治疗。
第一组，在接受曲安奈德病灶内注射混悬液2周后，12个睑板腺囊肿中有9个（75%）消退。2次注射2周后，2个睑板腺囊肿消退，第3次注射后1个消退。尽管有所改善，但3例患者抱怨有复发或新的相邻病灶出现。2例患者经皮注射部位有黄色沉积物。第二组，第一次手术后12个病灶中有9个（75%）消退，另外3个病灶经重复手术有反应。在消退后约1个月，2例患者出现旧病灶相邻部位复发或出现新病灶。第三组，2周后所有患者（12/12，100%）病灶均消退，且未出现复发或并发症。
这三种手术方法安全、有效且便捷。病灶内注射皮质类固醇对儿童、对局部麻醉过敏的患者、靠近泪道系统的睑板腺囊肿患者是一种很好的手术方法，并且对眼科医生以外的医生来说也很方便。对于感染性睑板腺囊肿患者，建议采用切开刮除术。切开刮除术联合病灶内注射皮质类固醇对大的、复发性和多发性睑板腺囊肿患者更为方便。
