Chalazion treatment: Surgical and non-invasive solutions

What is a chalazion?

A chalazion is a small bump that appears on the eyelid due to the blockage of a Meibomius gland. These glands, located on the inside of the eyelids, are responsible for producing a thin layer of sebum that protects the surface of the eye. When one of these glands becomes obstructed, it can become inflamed, leading to the formation of a mass that is painless at first, but can grow and become uncomfortable over time.

Chalazions can disappear on their own, but in some cases they persist or become bothersome enough to require medical treatment. This article aims to provide information on the various treatment options, both surgical and non-invasive, available to help you get rid of this embarrassing condition. We'll look in detail at the procedures, what you can expect and the benefits of non-surgical alternatives that help minimize the risk of recurrence.

When is treatment necessary?

A chalazion is more than just an isolated bump on the eyelid; it's often a warning sign that the Meibomius glands are malfunctioning. These glands are essential for the production of a protective oil that prevents tear evaporation and maintains the health of the ocular surface. When these glands become repeatedly blocked, it indicates an underlying problem that requires careful evaluation. Ignoring these signs can not only prolong discomfort, but also increase the risk of recurrence.

An assessment of risk factors is therefore essential to understand why the chalazion has formed and how best to manage the situation in the long term. Underlying causes may include conditions such as rosacea, blepharitis or poor eyelid hygiene. Accurate diagnosis and appropriate management are needed to reduce the risk of further glandular obstructions, and thus prevent the recurrence of chalazions.

Surgical treatments for chalazion

Incision and curettage

Incision and curettage is a common and effective surgical procedure for treating chalazions, especially when they don't respond to conservative treatments such as hot compresses or antibiotics. Here's what the procedure involves.

Description of the surgical process

The aim of incision and curettage is to remove the obstructed contents of the affected Meibomius gland, in order to relieve symptoms and prevent recurrence. The procedure involves a number of simple steps that are well mastered by healthcare professionals:

Preparation:

• The procedure is performed on an outpatient basis, in a dedicated operating room.
• The surgeon examines the eyelid to confirm that the operation is still necessary.
• A local anesthetic is injected into the eyelid at the level of the chalazion.
• This step may be slightly painful for a few seconds.

Surgical procedure :

• Special forceps are placed around the chalazion to turn the eyelid and control bleeding.
• The surgeon makes a small incision, usually on the inside of the eyelid.
• The contents of the chalazion are then emptied with a curette.
• This stage can be sensitive but painless thanks to anaesthesia.

Post-operative care :

• An antibiotic ointment is applied to the incision site to prevent infection.
• A compression bandage can be placed over the eye for a few hours to limit post-operative swelling.
• The patient receives instructions for home care, which includes the application of warm compresses and the use of an antibiotic ointment for a few days.

What to expect during the procedure

The procedure is generally very quick, taking around 15 to 20 minutes from start to finish. Thanks to the local anaesthetic, the patient feels no pain during the procedure, only a slight pressure. After the operation, most patients can return home the same day, without the need for hospitalization.

Potential risks

As with any surgical procedure, incision and curettage entail certain risks, although these are relatively rare:

• Infection: Although strict hygiene measures are observed, there is a slight risk of infection, generally avoided by the application of antibiotic ointments.
• Scars: Since the incision is made inside the eyelid, the risk of visible scarring is minimal.
• Healing time: Most patients experience improvement within a few days to a week, with a gradual reduction in swelling.

Success rate and recidivism

Incision and curettage are highly effective in removing a chalazion. A 2018 study of 1498 consecutive cases revealed an overall success rate of 92.4%. This means that most patients see their chalazion disappear completely after the procedure. However, recurrence can occur, if underlying factors such as Meibomius gland dysfunction are not properly managed.

Steroid injections

Steroid injection is a less invasive alternative to surgery for the treatment of chalazions. It aims to reduce the inflammation of the chalazion without requiring an incision. This method is particularly useful for chalazions that are inflammatory but small in size.

Treatment description :

Steroids, often triamcinolone acetonide-based, are injected directly into the chalazion to target inflammation within the blocked gland. A typical dose ranges from 0.1 to 0.2 ml of a 40 mg/ml solution of triamcinolone acetonide. The steroid works by reducing the body's inflammatory response, allowing the chalazion to gradually resolve.

When is this option preferred?

Steroid injections are preferred in the following situations:

• Persistent chalazions: This option is often used after conservative treatments such as warm compresses, eyelid hygiene and topical antibiotics have failed.
• Alternative to surgery: For patients who prefer to avoid surgery, steroid injection is a less invasive solution with comparable success rates.
• Small chalazions: Injections are particularly effective for small chalazions (less than 2 mm), where surgery may be considered excessive.

Efficiency

Clinical studies have shown a high resolution rate for steroid injections.

For example:

• One study revealed a complete resolution rate of 87.5% with triamcinolone injection at 40 mg/ml, compared with 66.6% for a lower concentration of 10 mg/ml.
• Another study showed that steroid injections offered a success rate of 82.5%, very close to that of incision and curettage (77.5%).

Possible side effects

Although generally well tolerated, steroid injections carry certain minor risks:

• Yellow-white deposits on the eyelids: observed in a few patients, these deposits are temporary and disappear over time.
• Elevation of intraocular pressure: Rare but possible, this was reported in two out of 32 patients in one study, requiring monitoring in patients at risk.
• Skin discoloration: In some cases, the injection may cause local skin discoloration, particularly in darker-skinned patients.

Steroid injections are therefore an attractive option for patients with smaller, more inflammatory chalazions. They offer an effective alternative to surgical treatment, while reducing the risk of more serious side effects. However, for larger or recurrent chalazions, other options may be required.

Non-invasive treatments for chalazion

Intense pulsed light (IPL)

IPL (Intense Pulsed Light): How IPL reduces the risk of chalazion recurrence

Intense Pulsed Light (IPL) is a non-invasive method that has proved particularly effective in reducing the recurrence of chalazions. It works by improving the function of the Meibomius glands, located in the eyelids, by heating the area to fluidify oil that may be blocked. This blockage is one of the main causes of chalazions. By helping these glands to function better, IPL helps to reduce inflammation and prevent the formation of new chalazions.

The mechanism is simple: IPL not only treats the existing chalazion, but also prevents recurrence by directly addressing the source of the problem, i.e. the malfunctioning of the Meibomius glands. By unblocking the glands and reducing dilated blood vessels, it limits the spread of inflammation that can lead to the reappearance of chalazions.

Expected results

Results from clinical studies show that IPL has a significant effect on reducing recurrence. For example, one study showed that 70.5% of patients treated with IPL had their chalazion disappear or significantly reduce in size, and more importantly, had a much lower rate of recurrence compared to conventional surgical treatments.

Another study from 2024 highlighted that IPL was particularly effective in treating large, recurrent chalazions. The success rate in these patients was 85.71%, demonstrating IPL's effectiveness in preventing future glandular obstructions.

Benefits of IPL in preventing recurrence

The benefits of IPL go beyond simply reducing ongoing chalazion. Its real strength lies in its ability to :

• ‍Preventrecurrences: Improving Meibomian gland function with IPL significantly reduces the risk of chalazion recurrence.‍
• Non-invasive: Without surgery or incision, IPL offers a gentle solution for treating chalazions while reducing the risk of long-term recurrence.‍
• Suitable for difficult chalazions: For patients suffering from recurrent chalazions, IPL has proved more effective than traditional treatments such as hot compresses or even surgery.

Thus, IPL is not only an effective method for treating existing chalazions, it is above all a lasting solution for preventing recurrences, by directly addressing the underlying cause: Meibomian gland dysfunction.ow IPL works to treat chalazions: improved Meibomian gland function, reduced inflammation.

Photobiomodulation (LLLT): An innovative treatment option

Having examined the benefits of Intense Pulsed Light (IPL) in the management of chalazions, it's important to look at another equally promising non-invasive method: photobiomodulation, or Low Level Light Therapy (LLLT). Like IPL, this approach aims to treat the source of the problem while considerably reducing the risk of recurrence. However, photobiomodulation is distinguished by its unique mechanism, which directly stimulates tissue healing and painlessly reduces inflammation.

Photobiomodulation, also known as low-level light therapy (LLLT), is an innovative method for treating chalazions non-invasively. This technique uses specific wavelengths of light, usually in the red or near-infrared spectrum, to stimulate tissue healing, reduce inflammation and improve Meibomian gland function.

Principle and mechanism of action

The principle of photobiomodulation is based on the application of low-intensity light to the affected area, through a mask or specific device. This light penetrates the skin and underlying tissues to produce several beneficial effects:

• ‍Stimulation ofATP production: increased cellular energy production promotes the regeneration of damaged tissue.‍
• Reduced inflammation: Light reduces inflammatory markers, relieving the discomfort and swelling associated with chalazion.‍
• Antibacterial effect (blue light): Certain wavelengths, such as blue, have an antimicrobial effect that helps prevent potential bacterial infections.

By improving tissue health and reducing inflammation, photobiomodulation facilitates the natural healing of chalazions while preventing their recurrence.

Efficiency

Clinical studies have shown that photobiomodulation can be highly effective in the treatment of chalazions, particularly in recalcitrant cases that do not respond to more traditional treatments. For example, one study reported complete resolution of chalazion in 46% of patients after a single 15-minute session, and up to 92% after two sessions. These results are particularly encouraging for patients who have tried other treatments without success.

Treatment protocol

Photobiomodulation treatment is simple and well tolerated:

• Session length: Each session generally lasts between 15 and 30 minutes.
• Frequency: If necessary, treatment can be repeated every three weeks.
• Combination with other therapies: To enhance results, photobiomodulation can be combined with techniques such as manual expression of the Meibomius glands, which involves squeezing the glands to remove blocked oil.

Advantages of photobiomodulation

Photobiomodulation offers many advantages over traditional treatments:

• Non-invasive and painless: Unlike surgery or injections, photobiomodulation requires no incision or physical manipulation, offering a comfortable solution for the patient.
• No recovery time: After a session, patients can immediately resume their daily activities without any restrictions.
• Reduced risk of recurrence: as with IPL, photobiomodulation helps restore the function of the Meibomian glands, significantly reducing the risk of chalazion recurrence.
• Overall improvement in eye health: In addition to treating chalazions, photobiomodulation improves overall eyelid and gland health, which is beneficial for preventing other eye problems.

Comparison with other treatments

Compared with methods such as incision and curettage, photobiomodulation offers a non-surgical alternative with far fewer risks of complications. It can also be used in conjunction with other non-invasive therapies, such as IPL, to optimize results, especially in the most complex or refractory cases.

Jett Plasma: An innovative approach to chalazion treatment

Although Jett Plasma technology is mainly used in aesthetic treatments, its unique properties also offer interesting potential in the treatment of chalazions. This non-invasive, plasma-based method could provide a new solution for reducing inflammation and accelerating healing of chalazions without recourse to surgery.

Operating principle

Jett Plasma uses electric arc technology to generate plasma, an ionized gas considered to be the fourth state of matter. This plasma creates controlled heat on contact with the skin, producing several beneficial effects that can be applied to the treatment of chalazions:

• Stimulation of collagen production: Plasma promotes tissue regeneration by stimulating collagen production, accelerating repair of affected areas.
• Anti-inflammatory effect: the heat generated by the plasma helps reduce local inflammation, a key factor in the treatment of chalazions.
• Antibacterial action: Plasma also has antibacterial properties, which can prevent or treat the potential infections that sometimes accompany chalazions.

Potential application to chalazions

Although the use of Jett Plasma to treat chalazions is still in the research phase, its effects on inflamed and obstructed tissue offer promising prospects. Here's how this technology could be applied in the treatment of chalazions:

• Reduced inflammation: the heat produced by the plasma helps reduce inflammation of the Meibomian glands, responsible for chalazion.
• Liquefaction of secretions: One of the major problems with chalazions is the blockage of secretions from these glands. Plasma can help liquefy these secretions and facilitate their evacuation.
• Stimulation of healing: Plasma promotes repair of damaged tissue and accelerates the healing process, reducing the duration of symptoms.

Potential benefits of Jett Plasma for chalazions

Using Jett Plasma to treat chalazions has several advantages over surgical methods and other invasive options:

• Non-invasive: Unlike incision and curettage, Jett Plasma requires no surgical intervention, reducing the risk of scarring and infection.
• Speed: A Jett Plasma treatment session is generally rapid, lasting between 5 and 15 minutes depending on the area treated. Patients can often return to their daily activities immediately after treatment.
• Few side effects: Side effects are usually minimal and temporary, such as slight redness or a sensation of localized heat, which disappear rapidly.

Although more research is needed to validate the use of Jett Plasma in the treatment of chalazions, this approach appears to offer an attractive alternative to traditional methods. Its ability to reduce inflammation, liquefy secretions and accelerate healing, while being non-invasive and rapid, makes it a potential solution for patients seeking to avoid surgical treatment. Jett Plasma could thus become a new therapeutic option in the management of chalazions, particularly for those seeking gentle, effective solutions.ow plasma can help reduce or eliminate a chalazion without incision.

Conclusion: Making the right treatment choice

It is essential to consult a healthcare professional to assess the severity of a chalazion, as each case is unique and requires a tailored approach. The size of the chalazion, how long it has been present, and the patient's preference for non-invasive or surgical methods are all factors to be taken into account when choosing a treatment.

At Clinique CARE, we offer personalized assessments to guide you toward the most appropriate treatment, whether through non-invasive methods like IPL, photobiomodulation or Jett Plasma, or more traditional solutions like incision and curettage. Book a consultation today and benefit from the expertise of our optometrists to effectively treat your chalazion and prevent recurrence.

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