Incision and curettage is a surgical procedure used to treat chalazion. Incision refers to a surgical cut made on the skin, while curettage is a surgical procedure that involves the removal of tumours by scraping out the lesion's tissues.
A chalazion is a benign swelling, lump or cyst that may appear on both the upper and lower eyelid. About 10% of all benign eyelid lesions are chalazia. It is caused by the blockage of the sebaceous glands (meibomian or Zeiss), which are responsible for producing oil. Inflammation, infections or lesions could cause the obstruction. The blockage causes the eyelid to turn red and swell, causing a lump to form.
A chalazion is typically painless and about 43% of chalazion go away on their own within eight weeks. However, some keep growing and cause discomfort in the surrounding tissue along with pain, due to the enlargement of the terminal branches of the ophthalmic or maxillary sensory nerve endings. It could also cause reversible vision changes due to compression of the cornea.
It is commonly noted in people between 30 and 50 years of age who have a history of acne, rosacea, seborrhea or chronic blepharitis.
Also Known As
- Chalazion surgery
- Chalazion incision and curettage
Before the Procedure
The patient will give their medical history including any medications being taken, previous surgical operations, allergies and reactions to drugs that affect blood coagulation. They should also mention health conditions such as sleep apnea or snoring, that could lead to complications with anaesthesia. They should also let the doctor know if they've reacted to anaesthesia before.
If the patient wears any nail polish or artificial nails, they could be asked to remove them. This is because the nail bed colour indicates blood circulation while under anaesthesia. The surgeon will give the patient specific instructions on what to eat or drink before the surgery.
The patient will also be required to sign a consent form that stipulates they understand the risks associated with the surgery.
Before the procedure begins, the patient will need to empty his/her bladder, change into a surgical gown and remove any jewellery.
The procedure may be conducted in a hospital or an eye specialist’s office. To begin, the surgeon gives the patient local or general anaesthesia. Once the anaesthesia takes effect, the surgeon uses a chalazion clamp to keep the eye open and turn it backwards. S/he then makes an incision using a surgical blade. If the chalazion is large, the incision is made on the outer eyelid. If it's smaller, the incision is made on the inner eyelid.
The surgeon then takes out the inflammatory debris of the cyst and thoroughly cleans out the cavity. S/he finishes by closing the incision with dissolvable stitches. The eye is compressed with gauze for 15 minutes to stop the bleeding. If the patient has experienced recurrent chalazion, the surgeon could opt to do a biopsy on the specimens scrapped from the eyelid.
The procedure takes 10 minutes, but with preparation and anaesthesia it could take up to 45 minutes.
Risks & Complications
There is a chance that the patient could develop some side effects to the anaesthesia, including nausea and sore throat. This shouldn't occur if the patient gives their health history to the anesthesiologist.
Although this surgery is simple, it does have a few risks. They include:
- Trauma to the eyeball and its surrounding structures
- Damage to the tear glands
- Recurrence of the chalazion
- Scarring - If the incision is made under the eyelid, there’ll be no external scar
The patient should immediately seek medical care in case they experience any of the following:
- Thick, yellow or green discharge from the incision
- High fever (Higher than 38°C or 101°F)
- Increased or uncontrollable pain
- Swelling that doesn't go away
- Excessive bleeding
Aftercare & Recovery
If the patient experiences swelling, s/he could use a cold compress on the eye for a few hours after the surgery. The eye is padded for a day. In case the eye leaks, the patient may need to apply moist heat to the site for five days, three times a day for ten minutes at a time, to help the wound drain and reduce the chances of the chalazion returning.
The patient will be prescribed topical antibiotics to keep the site from being infected and a steroid ointment to control inflammation.
The incision takes about ten days to fully heal. Until it does, the patient should maintain good hygiene and avoid getting water into the eye, wearing contact lenses, wearing makeup or rubbing the eye.
After a few weeks, the patient will be asked to go back to the eye specialist's office for a follow-up. Sometimes the incision may need to be repeated.
The procedure has been proven effective in preventing further infection and recurrence.