August 27, 2007
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Ethanolamine oleate sclerotherapy more effective than aspiration for orbitopalpebral cysts

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Using ethanolamine oleate sclerotherapy to manage orbitopalpebral cysts associated with congenital microphthalmos is linked with a significantly lower recurrence rate compared with simple cyst aspiration, a small retrospective study found.

Milind N. Naik, MD, and colleagues reviewed outcomes for 12 cysts of eight patients, all of whom had congenital microphthalmos. Surgeons treated five cysts with aspiration only in two patients at a median age of 12 weeks. Seven cysts in six patients were treated with aspiration and ethanolamine oleate sclerotherapy at a median age of 30 weeks, according to the study.

Follow-up averaged 8.8 months, ranging from 3 months to 23 months.

Of the five cysts treated with aspiration alone, only one (20%) showed complete resolution. In contrast, six of the seven cysts (85.7%) treated with ethanolamine oleate sclerotherapy showed complete resolution (P = .072), the authors reported.

One cyst in the ethanolamine oleate group required repeated sclerotherapy, and one cyst showed only partial resolution at 6 weeks postop, according to the study.

"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," the authors said. "Minimally invasive [ethanolamine oleate] 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."

The study is published in the July/August issue of Ophthalmic Plastic and Reconstructive Surgery.