Congenital microphthalmos with orbital cysts: distinct diagnostic features and management.

PURPOSE: To review the clinical features and treatment strategies for microphthalmic globes with orbital cyst.

METHODS

: The clinical records of 23 patients treated for microphthalmos associated with orbital cysts were reviewed retrospectively.

RESULTS

Most cases of congenital microphthalmos with orbital cysts were first noted at birth, and all were confirmed by means of computed tomography and/or ultrasonography. Six of the 23 cases were bilateral. Sixty-seven percent of bilateral and 29% of unilateral cases also had other congenital malformations. Mild microphthalmos was noted in 3 orbits, moderate in 16 orbits, and severe in 10 orbits. On the basis of clinical findings, 8 orbits were treated with enucleation and cyst excision and 15 were treated with cyst excision only. Cyst aspiration was performed on 5 orbits; 2 required aspiration and subsequent cyst excision. Twenty-six orbits had good cosmesis and 2 had acceptable cosmesis. The mean follow-up interval was 5.15 years.

CONCLUSIONS

Management of microphthalmos with orbital cyst is a cosmetic issue. Cyst size, degree of microphthalmos, and general condition of the patient determine the best treatment approach.