Individualized Treatments Tied to Favorable Outcomes for Patients With MIAN Cysts

A pediatric practice in Lausanne, Switzerland
A pediatric practice in Lausanne, Switzerland. Eye examination. (Photo by: BSIP/Universal Images Group via Getty Images)
Orbital cysts may be present in approximately 16% of all patients with microphthalmia and anophthalmia, a study suggests.

Patient-specific treatment plans are associated with favorable long-term outcomes in the management of microphthalmia and anophthalmia (MIAN)-associated orbital cysts, according to an investigation published in the British Journal of Ophthalmology. 

The investigators retrospectively reviewed 89 eye sockets of 78 patients with MIAN-associated orbital cysts, who were evaluated at a single prosthetics clinic, in Italy, between January 1988 and February 2020. The mean age at presentation was 2.8 years (range: 9 days to 29.5 years). According to the report, cysts were clinically identified (48%) or were incidental findings (52%). The average follow-up time was 7.2 years (range: 6 months to 28 years). The study also found that 11/82 cysts (13%) resolved or shrunk spontaneously, and 6/82 (7%) grew in volume. In total, 46% of cysts were excised surgically, while the remainder were retained. According to the satisfaction surveys of 75 patients, cosmetic outcomes were rated as ‘excellent’ or ‘good’ in 90% of cases by physicians and 97% of cases by patients or guardians. 

“The favorable long-term outcomes in this study have resulted from bespoke plans which considered periocular tissue development, regional orbital growth and orbital volume replacement,” the study authors stated. “The authors contemplate cyst excision if the prosthetic fitting or retention is impeded by the cyst as this often heralds the increased risk of long-term periocular distortion.”

A limitation of the research is the retrospective design. 

Based on the current study, researchers estimate that orbital cysts may be present in approximately 16% of all patients with MIAN, however, not all will be clinically identified. 

Due to the rarity and challenging nature of MIAN-associated cysts, the investigators recommend “that they should receive input of specialist teams.” They also stress that treatment decision making should be “based on individual patient, cyst, and socket characteristics.”


Gore S, Grimaldi G, Mazzone G, et al. Treatment strategies and long-term outcomes in patients with congenital microphthalmia-anophthalmia with cyst. Published online January 31, 2022. Br J Ophthalmol. doi:10.1136/bjophthalmol-2020-318089