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Marking technique to improve primary success of incision and curettage of eyelid chalazia

Eyelid chalazia are a common presentation to the ophthalmologist. If conservative management has failed, surgical intervention may be indicated. Incision and curettage of the cyst is a straightforward procedure, but can be unsatisfying for both patient and clinician if the cyst is incompletely drained. Previous reviews of incision and curettage for chalazia have demonstrated success rates between 60% and 89% (refer to Jackson and Beun). A higher chance of success may be achieved with more accurate surgery using a method that may improve locating the centre of the cyst once the clamp is placed. Two distinct parts of the traditional procedure make locating the centre of the cyst more difficult. Firstly, the infiltration of local anaesthetic often distorts the eyelid anatomy, and secondly, the opaque anterior surface of the chalazion clamp obscures direct vision of the cyst, hampering central clamp placement, which is necessary for an optimally placed incision (Figs 4,5). Here, the authors describe a marking technique developed by Dr Jonathan Kam to aid positioning of the chalazion clamp and therefore improve placement of the conjunctival incision. (Figs 1–6). The technique has been taught to colleagues with excellent reproducibility. The authors hope this marking method improves the success and