EC Ophthalmology

Purpose: The aim of this paper is to investigate the usefulness of the laser beam as a hot blade to remove the chalazion while the patient is sitting with his head positioned in front of the slit-lamp microscopy.

Materials and Methods: This prospective, observational study included 3475 chalazia from 2640 patients including 1543 males and 1097 females, mean age 41,2 (11 - 90 years), who underwent surgery using laser photocoagulation with the transconjunctival approach. 356 patients had more than one chalazion. The patient's head is placed in front of the slit-lamp biomicroscope, his eyelid was fixed with a chalazion clamp and a vertical laser incision of the palpebral conjunctiva (inner chalazion) and tarsus (outer chalazion) is performed with a laser photocoagulator. The chalazion contents were curetted and removed. Patients were followed at 15 and 30 days.

Results: Fifteen days after surgery, 3426 chalazia (98.6%) were removed and patients recovered. In 49 cases (1.4%), redness and swelling of the eyelid persisted due to the presence of granuloma residues. After fifteen days of antibiotic-steroidal ointment treatment, 20 cases (0.6%) were cured, while in the other 29 cases (0.8%) their residues were completely removed with the same surgical technique. After thirty days the chalazion was not palpable in all cases.

Conclusion: This procedure is simple, fast, effective, safe and well tolerated by patients. Additionally, simultaneous hemostasis using laser photocoagulation lowers the risk of bleeding and leads to early eyelid edema resolution with an excellent cosmetic result. This technique is contraindicated in non-cooperative patients requiring anesthesiological assistance.

 Keywords: Chalazion; Meibomian Gland; Eyelid; Laser Photocoagulation; Microsurgery

1. Evans J., et al. “Chalazion: racial risk factors for formation, recurrence, and surgical intervention”. Canadian Journal of Ophthalmology 4 (2022): 242-246.
2. Kim DH., et al. “Risk factors for chalazion diagnosis and subsequent surgical excision”. Ophthalmic Epidemiology 1 (2024): 84-90.
3. Lempert SL., et al. “Chalazia and rosacea”. Archives of Ophthalmology 9 (1979): 1652-1653.
4. Aycinena AR., et al. “Incision and curettage versus steroid injection for the treatment of chalazia: a meta-analysis”. Ophthalmic Plastic and Reconstructive Surgery3 (2016): 220-224.
5. Ben Simon GJ., et al. “Intralesional triamcinolone acetonide injection versus incision and curettage for primary chalazia: a prospective, randomized study”. American Journal of Ophthalmology4 (2011): 714-718.
6. Nabie R., et al. “A prospective randomized study comparing incision and curettage with injection of triamcinolone acetonide for chronic chalazia”. Journal of Current Ophthalmology3 (2019): 323-326.
7. Tashbayev B., et al. “Chalazion treatment: A concise review of clinical trials”. Current Eye Research 2 (2024): 109-118.
8. Sendrowski DP and Maher JF. “Thermal cautery after chalazion surgery and its effect on recurrence rates”. Optometry and Vision Science 11 (2000): 605-607.
9. Mawatari Y., et al. “The usefulness of diathermy thermocoagulation in chalazion surgery”. Clinical Ophthalmology 17 (2023): 579-582.
10. Zhu Y., et al. “Efficacy of intense pulsed light in the treatment of recurrent chalaziosis”. Frontiers in Medicine 9 (2022): 839908.
11. Procope JA and Kidwell ED Jr. “Delayed postoperative hemorrhage complicating chalazion surgery”. Journal of the National Medical Association 11 (1994): 865-866.
12. Duarte AF., et al. “Chalazion surgery: advantages of a subconjunctival approach”. Journal of Cosmetic and Laser Therapy 3 (2009): 154-156.
13. Prasad S and Gupta AK. “Subconjunctival total excision in the treatment of chronic chalazia”. Indian Journal of Ophthalmology 4 (1992): 103-105.