Background: The purpose of this case series was to further characterize proteasome inhibitor associated chalazia\nand blepharitis, to investigate outcomes of different management strategies, and to propose a treatment algorithm\nfor eyelid complications in this patient population.\nMethods: This retrospective case series included sixteen patients found to have chalazia and/or blepharitis while\nreceiving proteasome inhibitors for plasma cell disorders at Mount Sinai Hospital in New York, NY from January\n2010 through January 2017. Main outcomes were complete resolution of eyelid complications and time to resolution.\nStudentâ??s t-test was used to compare average values and Fisherâ??s exact test was used to compare proportions.\nResults: Fourteen patients had chalazia and 10 had blepharitis. Chalazia averaged 5.4 mm, and 11 patients with chalazia\nexperienced two or more lesions. Median follow-up time was 17months. Average time from bortezomib exposure to\nonset of first eyelid complication was 3.4 months. Chalazia episodes were more likely to completely resolve\nthan blepharitis episodes (p = 0.03). Ocular therapy alone was trialed for an average of 1.8 months before\nproceeding to bortezomib omission. Average time to eyelid complication resolution using ocular therapy\nalone was 1.8 months versus 3.1 months after bortezomib omission. In this series, the combination of ocular\ntherapy and bortezomib omission led to complete resolution of eyelid complications more often than ocular\ntherapy alone.\nConclusion: Proteasome inhibitor associated eyelid complications were identified in sixteen patients with\nplasma cell disorders. Eyelid complications may be treated with a 2-month trial of conservative ocular therapies alone,\nfollowed by continuation of ocular therapy in combination with bortezomib omission if eyelid signs persist.
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