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  • 1. Introduction
  • 2. Surgical Approach
  • 3. Apply Chalazion Clamp and Evert the Eyelid
  • 4. Incision
  • 5. Curettage
  • 6. Remove Chalazion Clamp and Revert the Eyelid
  • 7. Palpation to Confirm an Empty Cavity
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Incision and Curettage on a Left Upper Eyelid Chalazion

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Lilit Arzumanian, MD1; Alexander Martin, OD2; John Lee, MD2
1Vardanants Center for Innovative Medicine
2Boston Vision

Transcription

CHAPTER 1

Hello, my name is Dr. John Lee. I'm the oculoplastic and reconstructive surgeon for Boston Vision. I wanna describe to you a video of a chalazion incision and curettage. Once a decision is made to proceed with an incision, the area of the lid is anesthetized with 2% lidocaine and epinephrine on a 32 gauge needle. Once the area is fully anesthetized, it is clamped with a chalazion clamp of appropriate size. The lid is then everted over that clamp, exposing the palpebral surface. That surface is then incised with a number 11 blade. A curette is then introduced through that incision site and used to empty out the chalazion cavity. Once that's complete, the clamp is removed and the patient can be discharged.

CHAPTER 2

So we're gonna do an incision and curettage on a left upper lid chalazion. She already has some lidocaine infiltrated in this area, so should be quite comfortable. We always have some more medication if you start feeling some pain.

CHAPTER 3

This chalazion clamp has a solid backside and an open front. We will put the open side posteriorly, put it over the chalazion and squeeze. So this is the part I told you you're gonna be feeling a little pressure. It has a screw type lock on the clamp, feeling that pressure. And then we go ahead evert the lid. Who's taking a picture of that for me? It's all gonna be on video for us.

CHAPTER 4

Okay, this is a number 11 blade. Make an incision through the tarsal plate, and you can see the lipogranulomatous material is starting to come out.

CHAPTER 5

And we have a small curette, through the incision... And you can start to see the lipogranulomatous material coming out there. Are you having pain? No, just weirdness. Definitely weird. Just, just... Not an everyday experience, is it? What are you doing now? Not an everyday experience for you, is it? No. What's happening now? So I'm actually just scooping out all that stuff in there. Okay. It's coming out very nicely. Now, do you test that or not? No. And the idea is to take out the entire cavity, scrape around. Occasionally you will feel some scar material. Oh, that hurt. Okay.

CHAPTER 6

Release the clamp, put the lid back into its position.

CHAPTER 7

And palpate around. I don't feel any nodule there anymore. I'll palpate from both sides to confirm that it is indeed an empty cavity. It is. You are all done. So, right now the treatment is pressure. So I'm gonna go ahead and after the drape comes off, I'm gonna have you put your hand up there and hold some pressure, and then we'll be all done. Okay.