RT Journal Article SR Electronic T1 Treatment strategies and long-term outcomes in patients with congenital microphthalmia–anophthalmia with cyst JF British Journal of Ophthalmology JO Br J Ophthalmol FD BMJ Publishing Group Ltd. SP bjophthalmol-2020-318089 DO 10.1136/bjophthalmol-2020-318089 A1 Sri Gore A1 Gabriela Grimaldi A1 Giacomilde Mazzone A1 Richard Collin A1 Gustavo Savino A1 Mario Pagnoni A1 Alessandra Modugno YR 2022 UL http://bjo.bmj.com/content/early/2022/01/30/bjophthalmol-2020-318089.abstract AB Background/Aims Microphthalmia and anophthalmia are rare conditions, which represent ocular maldevelopment; both may be associated with orbital cysts. Current literature recommends retention to stimulate orbital growth during socket rehabilitation but does not illustrate their potential to deform the periocular tissues. This study aims to illustrate the long-term outcomes when other elements, such as forniceal and lid development, are also considered when formulating bespoke treatment plans for patients.Methods Retrospective case series of 78 patients attending a single prosthetics clinic between 1988 and 2020. Clinical and surgical notes, radiological imaging, clinical photographs and patient/doctor satisfaction questionnaires were used to report patient outcomes and natural history data.Results 89 sockets of 78 patients (11 bilateral) were included; average age of presentation being 2.8 years (9 days to 29.5 years). Cysts were clinically detected (48%) or were incidental findings (52%). The mean follow-up time was 7.2 years (6 months to 28 years). Cysts in 46% of sockets underwent surgical excision while the remainder were retained. Satisfaction surveys were obtained for 75 patients, with cosmetic outcomes rated as ‘excellent’ or ‘good’ in 90% of cases by physicians and 97% of cases by patients or guardians.Conclusion The favourable long-term outcomes in this study have resulted from bespoke plans which considered periocular tissue development, regional orbital growth and orbital volume replacement. 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.All data relevant to the study are included in the article or uploaded as online supplemental information.