Iatrogenic Ocular Surface Complications After Surgery for Ocular and Adnexal Tumors
Author: Maria Angela Romeo
Base Hospital / Institution: Department of Ophthalmology, University Magna Graecia, 88100 Catanzaro, Italy
ePoster presentation
Abstract ID: 25-367
Purpose
To address iatrogenic ocular surface complications arising from surgery for ocular and adnexal tumors, examining their pathophysiological mechanisms, outlining management strategies, and emphasizing their relevance in preoperative planning and postoperative rehabilitation within oculoplastic practice.
Methods
A systematic literature review was conducted in January 2025 using multiple keyword strategies. A total of 2015 full-text articles were initially identified; after removal of duplicates and unrelated records, 549 were screened by abstract, and 137 full-text articles were reviewed. Of these, 92 studies were included. Reference list searches identified 42 additional sources.
Results
Ocular surface complications include direct damage from surgical manipulation, leading to corneal opacities and persistent epithelial defects, as well as dry eye disease secondary to postoperative chemosis. These disruptions may progress to more severe conditions such as keratopathy, corneal ulcers, limbal stem cell deficiency, and stromal scarring, further impairing visual function. Structural alterations contribute to eyelid malpositions—including ectropion, entropion, round eye and lagophthalmos— which exacerbate exposure-related damage and ocular surface instability. In cases of uveal melanomas, episcleral brachytherapy plaques exposure can induce chronic conjunctival irritation, promoting adhesion formation and symblepharon. Surgical interventions disrupt ocular surface homeostasis, while radiotherapy and chemotherapy exacerbate these effects through cytotoxic and inflammatory mechanisms. These complications are addressed through both preventive and therapeutic strategies including lubrication, immunomodulators, surgical revision and ocular surface reconstruction.
Conclusion
Successful prevention and management of iatrogenic ocular surface complications require multidisciplinary care and tailored perioperative strategies led by the oculoplastic surgeon, aiming to preserve visual function while ensuring oncologic control and functional–aesthetic outcomes.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Alessandra Di | Maria | Ophthalmology Unit, IRCCS Humanitas Research Hospital, Milano, Italy |
| Andrea | Taloni | Istituto Internazionale per la Ricerca e Formazione in Oftalmologia, Forlì, Italy |
| Massimiliano | Borselli | Ophthalmology Unit, University Magna Graecia, Catanzaro, Italy |
| Vincenzo | Scorcia | Eye Clinic, University of Cagliari, Italy |
| Giuseppe | Giannaccare |
