Personal Technique for Rapid Removal of Chalazion Using Laser Microsurgery

Purpose: the aim of this research is to evaluate the usefulness of a photocoagulator laser beam as a hot blade to remove the chalazion on an outpatient basis while the patient is seated with his head positioned in front of a slit-lamp microscope. Materials and methods: this prospective, observational study involved 3675 chalazia in 2840 patients, including 1643 males and 1197 females, with a mean age of 36.4 years (range 11-90 years). 462 patients had more than one chalazion. The patient’s head is positioned in front of the slit-lamp biomicroscope, his eyelid is fixed with a chalazion clamp and then a small vertical incision of the palpebral conjunctiva (internal chalazion) and tarsus (external chalazion) is performed with a Neodymium-doped Yttrium Aluminium Garnet Laser (532 nm laser photocoagulator). The surgical approach is always transconjunctival. The chalazion contents are curetted and removed. Patients were followed up at 15 and 30 days. Results: fifteen days after surgery, 3630 chalazia (98.8%) were completely removed with excellent functional and aesthetic results. In 45 cases (1.2%), redness and swelling of the eyelid persisted due to the presence of granuloma residues. After fifteen days of local treatment with antibiotic-steroid ointment, 20 cases (0.53%) healed, while in the other 25 cases (0.67%) the granuloma residues were removed using the same surgical technique. After thirty days, the chalazion was not palpable in all cases. Conclusion: this procedure proved to be simple, quick, effective, safe and well tolerated by patients. Furthermore, the use of the photocoagulator laser beam reduced the risk of bleeding, making the operating field dry and clearly visible thanks to the use of the biomicroscope, promoting rapid resolution of the eyelid oedema. The technique is contraindicated in uncooperative patients who require anaesthetic assistance.