Risk of dry eye syndrome after radiotherapy for orbital tumors: a systematic review and meta-analysis

This systematic review aimed to investigate the risk of developing dry eye syndrome following radiotherapy for orbital tumors. This study aimed to provide insights for formulating radiotherapy suggestions for orbital tumors and preventing dry eye syndrome.

This systematic review collected literature published in PubMed, EBSCO, and Web of Science prior to December 1,2025 concerning dry eye syndrome induced by radiotherapy for orbital tumors. 23 studies total 1,602 patients with orbital tumors were included across all studies. The review adhered to the PRISMA guidelines, with literature quality assessed using the Newcastle-Ottawa Scale (NOS) scale. All data analyses were conducted using Stata 17.

The overall prevalence of Dry Eye Syndrome (DES) after orbital radiotherapy was 31% (95% CI: 15-48%, P< 0.01), with high heterogeneity (I² = 98.56%). Subgroup analyses indicated higher DES incidence in patients aged ≥60 years (41% vs. 28%), those receiving ≥30 Gy (36% vs. 25%), and those with non-orbital lymphoma (39% vs. 29%). Longer follow-up (≥5 years) was associated with lower incidence (19% vs. 40%). No significant publication bias was detected.

Radiotherapy for orbital tumors significantly increases the risk of DES. Although statistical interactions were not significant, trends suggest that older age, higher radiation dose, and shorter follow-up may elevate DES risk, underscoring the need for tailored monitoring and preventive care.

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