Abstract
Purpose :
This study explores the use of intralesional 5-Fluorouracil (5-FU) injections as a minimally invasive and effective treatment for chalazia. Existing treatments for chalazia vary in terms of invasiveness and efficacy. Incision and drainage is generally a successful treatment, but it is invasive and is best done on chronic chalazia. Injection with triamcinolone has been associated with side effects such as increased intraocular pressure (IOP), hypopigmentation, and even central retinal artery occlusion (CRAO). Additionally, corticosteroid injections frequently lead to visible steroid depots. Warm compresses have limited effectiveness and often require an extended duration of treatment, which may be unacceptable for the patient.
5-FU application is a common treatment for cutaneous scarring; subjective evidence suggests potential in chalazia treatment, however its efficacy has not yet been demonstrated.
Methods :
138 cases of chalazions treated with injections of a 9:1 mixture of 5-FU:triamcinolone from two institutions were retrospectively reviewed. All cases with available data and a least 6 months since injection were assessed. Parameters evaluated included reduction in chalazion size, requirement for additional treatments, cosmetic result, and patient satisfaction. Patient-reported reduction in chalazia size of 80% or more was considered successful.
Results :
The study population included 138 chalazions from 128 subjects. 47% of the patients were male, and the average age at treatment was 52 years. Lesions were present an average of 4 months prior to treatment. In 81 cases (64%), a single injection of 5-FU was successful in reducing lesion size and improving cosmetic appearance, resulting in patient satisfaction with the outcome. Success rate was not affected by sex, race, or location of lesion. In two cases, an increase in punctate epithelial erosions was noted at the post-treatment visit. In both cases the ocular dryness resolved with topical lubricating eyedrops. There were no cases of hypopigmentation, increased IOP, or CRAO.
Conclusions :
Injection of 5-FU is an effective and minimally invasive technique for treatment of chalazia. Successful results were comparable to previous reports of triamcinolone acetonide injection, while reducing the potential for side effects and improving cosmetic outcome. Given the minimal amount of steroid used, future studies will aim to determine if 5-FU alone is an effective treatment for chalazia.
This is a 2020 ARVO Annual Meeting abstract.