Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Ophthalmology, Elmhurst Hospital Center, Elmhurst, New York, USA.
Acta Ophthalmol. 2018 Jun;96(4):e503-e509. doi: 10.1111/aos.13675. Epub 2018 Jan 16.
To assess the within-treatment efficacy of hot compresses (HC), HC plus tobramycin (Tobrex) and HC plus tobramycin/dexamethasone (Tobradex) for chalazia treatment.
Design: Multicentre, randomized clinical trial (ClinicalTrials.gov identifier, NCT01230593).
Two clinical sites in New York and two clinical sites in Ontario.
A total of 149 patients with one or more chalazia on separate eyelids randomly assigned to receive HC (n = 50), HC plus tobramycin (n = 50) or HC plus tobramycin/dexamethasone (n = 49).
4-6 weeks of assigned treatment. Patients were measured for chalazion horizontal width and surveyed for pain and treatment satisfaction levels.
Primary outcome was complete resolution (100% size reduction). Secondary outcomes were size change in millimetres and patient reported pre- and post-treatment pain and satisfaction levels.
In the intention-to-treat (ITT) population, complete resolution occurred in 36 (18%) lesions total, 13 (21%) treated with HC, 12 (16%) with HC plus tobramycin and 11 (18%) with HC plus tobramycin/dexamethasone, with no significant difference between them (p = .78). Individually by paired t-test, there were statistically significant post-treatment mean size differences: HC 1.20 mm (p < 0.001), HC plus tobramycin 1.69 mm (p < .001) and HC plus tobramycin/dexamethasone 1.54 mm (p < 0.001), but no significant difference between them (p = .61). Lesions that completely resolved had a statistically significant lower pretreatment duration (1.5 months) compared to lesions that did not completely resolve (2.2 months) (p = .04).
Hot compresses (HC) alone or in combination with tobramycin or tobramycin/dexamethasone drops and ointment are all effective first-line treatment options for chalazia. However, physicians may consider moving directly to the use of more invasive therapies, such as incision and curettage or steroid injections, for chalazia that have been present for more than 2 months, as older lesions are less likely to resolve with conservative therapies alone.
评估热敷（HC）、HC 加妥布霉素（Tobrex）和 HC 加妥布霉素/地塞米松（Tobradex）治疗睑板腺囊肿的治疗内疗效。
设计：多中心、随机临床试验（ClinicalTrials.gov 标识符，NCT01230593）。
纽约的两个临床地点和安大略省的两个临床地点。
共有 149 名患有单眼或双眼睑板腺囊肿的患者，随机分为接受 HC（n=50）、HC 加妥布霉素（n=50）或 HC 加妥布霉素/地塞米松（n=49）治疗的患者。
4-6 周的指定治疗。测量睑板腺囊肿的水平宽度，并调查疼痛和治疗满意度水平。
主要结局为完全缓解（100%大小减小）。次要结局为毫米大小变化以及患者报告的治疗前后疼痛和满意度水平。
在意向治疗（ITT）人群中，总共有 36 个（18%）病变完全缓解，13 个（21%）接受 HC 治疗，12 个（16%）接受 HC 加妥布霉素治疗，11 个（18%）接受 HC 加妥布霉素/地塞米松治疗，它们之间没有显著差异（p=0.78）。通过配对 t 检验，各组治疗后平均大小差异具有统计学意义：HC 组 1.20mm（p<0.001），HC 加妥布霉素组 1.69mm（p<0.001），HC 加妥布霉素/地塞米松组 1.54mm（p<0.001），但它们之间无显著差异（p=0.61）。完全缓解的病变预处理持续时间（1.5 个月）明显低于未完全缓解的病变（2.2 个月）（p=0.04）。
单独使用 HC 或联合使用妥布霉素或妥布霉素/地塞米松滴眼液和软膏都是治疗睑板腺囊肿的有效一线治疗选择。然而，对于已经存在超过 2 个月的睑板腺囊肿，医生可能会考虑直接采用更具侵入性的治疗方法，如切开刮除或类固醇注射，因为较老的病变单独使用保守治疗不太可能缓解。
