Investigating orbital foreign device-associated malignancies: a scoping review

While prosthesis-associated malignancies have been acknowledged, awareness among surgeons and patients in the ophthalmologic field remains limited, despite the frequent occurrence of prosthesis-related surgeries. We aim to address this gap through a scoping review of malignancies following ophthalmologic surgeries involving various foreign device/prosthesis/implants.

Following PRISMA guidelines, we conducted a review using PubMed and Embase for studies on cancer and ophthalmic prostheses/implants. The final selection of articles for the ophthalmology aspect underwent rigorous investigation.

We analyzed 30 studies, identifying 41 cases of malignancies following interventions involving orbital foreign devices. Foreign devices linked to malignancies included scleral shells, orbital implants, scleral buckles, encircling bands, and gold plates. Ocular surface squamous neoplasm was most common, with 29 cases. Other malignancies observed were pleomorphic sarcoma, synovial sarcoma, marginal zone B-cell lymphoma, sebaceous carcinoma, malignant melanoma, adenocarcinoma, and metastatic lung adenocarcinoma. These malignancies varied in characteristics and demographics, with some showing metastasis or local invasion. The median time to tumor development was 40 years.

This study highlights a spectrum of malignancies following orbital foreign device procedures and suggests a potential association between different types of orbital foreign devices and malignancies. Future studies, including well-designed epidemiologic studies and scientific experiments, are warranted to elucidate the causal relationship.