Ethanolamine oleate sclerotherapy versus simple cyst aspiration in the management of orbitopalpebral cyst associated with congenital microphthalmos

Ophthalmic Plast Reconstr Surg. Jul-Aug 2007;23(4):307-11. doi: 10.1097/IOP.0b013e3180987243.

Abstract

Purpose: 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.

Publication types

  • Comparative Study

MeSH terms

  • Child, Preschool
  • Cysts / complications
  • Cysts / therapy*
  • Eyelid Diseases / complications
  • Eyelid Diseases / therapy*
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Microphthalmos / complications*
  • Oleic Acids / therapeutic use*
  • Orbital Diseases / complications
  • Orbital Diseases / therapy*
  • Recurrence
  • Sclerosing Solutions / therapeutic use
  • Sclerotherapy / methods*
  • Suction / methods*
  • Treatment Outcome

Substances

  • Oleic Acids
  • Sclerosing Solutions
  • ethanolamine oleate