Combined 5-FU/triamcinolone reduces chalazion size
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Moran and colleagues evaluated chalazia treated with injections of a 9:1 mixture of 5-fluoruracil 50 mg/mL (Adrucil, Teva Pharmaceuticals) and triamcinolone acetonide 10 mg/mL (Kenalog-10, Bristol-Myers Squibb) in terms of invasiveness, safety, and efficacy. The therapy was compared with more traditional treatments, including injections with triamcinolone or incision and drainage. The retrospective study included 138 cases of chalazia injected with the 9:1 mixture and researchers evaluated the reduction in chalazion size, requirement for additional treatments, cosmetic results, and patient satisfaction. Treatment success was defined as the observed or patient-reported chalazion size reduction of 80% or more.

Researchers found a single injection of 5-FU/triamcinolone resulted in the successful treatment of 88 cases (64%). The injections successfully reduced lesion size, improved cosmetic appearance and resulted in patient satisfaction. Lower success rates were observed in patients requiring multiple injections. The average number of injections was 1.41 in the cohort, but success rates decreased with subsequent injections and no further improvements were observed after three injections, he said. Two cases resulted in post-treatment punctate epithelial erosions, which were resolved with topical lubricating eyedrops.

The 9 to 1 mixture drastically decreases the total amount of steroid that is used. Theoretically, this also minimizes the risk of side effects associated with triamcinolone injection, including hypopigmentation, which is of particular concern when treating patients with dark skin. This chalazion therapy can be used as an initial treatment for patients requesting expedited recovery. If a patient does not respond to a single injection of 5-FU, incision and drainage can be scheduled at a later date.