Ethanolamine oleate sclerotherapy versus simple cyst aspiration in the management of orbitopalpebral cyst associated with congenital microphthalmos.
OBJECTIVE
To evaluate the efficacy of ethanolamine oleate (EO) sclerotherapy in the management of orbitopalpebral cysts associated with congenital microphthalmos, and compare it with simple cyst aspiration.


METHODS
Retrospective, interventional comparative case series of 12 orbitopalpebral cysts of 8 patients associated with congenital microphthalmos. Five cysts were treated with simple aspiration and 7 cysts with EO sclerotherapy. Cyst resolution was the main outcome measure.


RESULTS
Five cysts underwent aspiration alone at a median age of 12 weeks. One (20%; 95% CI, 0%-55.1%) of these 5 showed complete resolution. Seven cysts (6 patients) underwent aspiration combined with EO sclerotherapy at a median age of 30 weeks (3 had recurred following prior cyst aspiration). Postsclerotherapy, 6 eyes (85.7%; 95% CI, 59.8%-100%) showed complete cyst resolution (p = 0.072, Fisher exact test). The mean follow-up was 8.8 months (range, 3-23 months). In the EO group, 1 cyst (14.3%) required repeat sclerotherapy and another cyst showed partial resolution at 6 weeks. The number needed to treat with sclerotherapy to prevent 1 recurrence was 2 (1-5, 95% CI). No procedure-related complications were noted.


CONCLUSIONS
Simple aspiration of orbitopalpebral cyst is associated with a high recurrence rate and should be reserved for early prognostication of visual potential in the microphthalmic eye. Minimally invasive EO sclerotherapy provides a rapid, effective, and uncomplicated treatment modality for definitive therapy, and should be preferred in cases with no visual prognosis in the microphthalmic eye demonstrating adequate bony orbital expansion.
Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Hyderabad, India. milind@lvpei.org
Milind N
MN
Naik
Santosh G
SG
Honavar
Ramesh K
RK
Murthy
Kuldeep
K
Raizada
Ravi
R
Thomas
D002675:Child, Preschool; D003560:Cysts / Q000150:complications / Q000628:therapy*; D005141:Eyelid Diseases / Q000150:complications / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008850:Microphthalmos / Q000150:complications*; D009829:Oleic Acids / Q000627:therapeutic use*; D009916:Orbital Diseases / Q000150:complications / Q000628:therapy*; D012008:Recurrence; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy / Q000379:methods*; D013396:Suction / Q000379:methods*; D016896:Treatment Outcome
D009829:Oleic Acids; D012597:Sclerosing Solutions; C033343:ethanolamine oleate