Purpose

Neoplasia in patients with anophthalmia is an underrecognized clinical problem. Detection may be hindered by the ocular prosthesis, potentially delaying diagnosis and treatment. This study aimed to characterize the localization of neoplasia within the anophthalmic socket, particularly in relation to prosthesis coverage, and to evaluate the spectrum and frequency of neoplasia in this population.

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Methods

This retrospective single-center study screened all clinical records and histopathological reports between 1986 and 2024. Inclusion criteria were neoplasia in an anophthalmic socket, including the eyelids. Lesions were categorized based on their localization to the prosthesis and histological diagnosis. Type of initial surgery and irradiation status were recorded. Descriptive statistics were used.

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Results

Thirty-two cases were identified, with 31% malignant lesions (10/32). These were squamous cell carcinomas (n=5), basal cell carcinomas (n=3), and single cases of malignant melanoma and conjunctival intraepithelial neoplasia (CIN III). Benign lesions included pyogenic granulomas, chronic inflammation, nevi, cysts, fibrotic proliferations, and one arteriovenous malformation. Half of all lesions, including two malignancies, were located beneath the prosthesis. Mean interval between anophthalmia and tumor detection was 21.1 years.

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Conclusion

Although rare, neoplasia in the anophthalmic socket may be life-threatening. As half of all lesions were covered by the prosthesis, thorough examination with prosthesis removal is essential.

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Additional Authors

First name	Last name	Base Hospital / Institution
Johannes Robert	Fleischer	Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
Daniel	Böhringer	Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
Thomas	Reinhard	Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
Cornelius	Wiedenmann	Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany

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