Incision and curettage of chalazion (meibomian cyst)
A meibomian cyst (also known as a chalazion) is a sterile, chronic, inflammatory granuloma of the eyelid, caused by the obstruction of a meibomian gland.
These are first treated with conservative measures, this could involve Hot Compresses, antibiotic ointment for three weeks and possibly oral antibiotics for ten days or so. Then, if these conservative measures do not work, the next option is to have an incision and curettage of the chalazion. The cyst or cysts is/are incised and drained from the inner aspect of the eyelid.
If the cyst is left (ie no surgical procedure is carried out), the cyst may continue to cause irritation and can affect vision due to astigmatism form the cyst pressing on the cornea.
Incision and curettage is usually carried out under local anaesthetic as an outpatient. Please note that it will need to be booked after your initial consultation; it is unlikely to be carried out on the same day as your clinic appointment.
Please make arrangements for someone to drive you home after surgery. You should be able to drive one or two days after surgery, depending on how swollen your eyelid is.
You may continue any medication you are currently taking. If, however, you take Warfarin you will need a Warfarin activity level (INR) taken within two days of surgery. This can be done by your GP or by the hospital.
Please do not apply moisturiser or make-up to your face on the day of surgery.
If you are having a local anaesthetic you may continue to eat and drink as usual.
The surgery itself
The procedure involves a local anaesthetic injection which may sting for 5-10 seconds. Eyedrops are usually placed in both eyes, even if the chalazion is only on one, to numb them prior to surgery so it is important that you are not wearing contact lenses.
A cleaning solution is then applied to the skin around the eye to make sure that it is sterile. Once the eyelid is numb, a small metal instrument is used to stabilise the eyelid whilst the cyst or cysts is/are incised and drained from the inner aspect of the eyelid.
If the cysts are recurrent then sometimes a specimen is submitted to pathology for laboratory analysis. This is not usually the case.
The surgery takes about two to three minutes of actual surgical time but the duration spent in theatre may be up to 15-20 minutes.
After the surgery there will likely be some bruising related to the anaesthetic injection and the operation. This may last a week. Sometimes an eye pad is applied for up to 24 hours to reduce bruising and swelling.
Post operatively a steroid antibiotic ointment is usually applied, by the patient, twice a day for two weeks.
It is very important that you let Mr McMullan know of any allergies you may have.
Risks associated with incision and curettage
Risks of the operation include infection, bleeding, and damage to lid structures but these risks are very rare. Further information - please request an EIDO leaflet.