The evolution of globe-preserving management for lacrimal gland carcinoma.

Vahdani, Kaveh; Verity, David Harding · Br J Ophthalmol · 2026

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Abstract

The historical evolution of globe-preserving management provides important context for interpreting contemporary outcomes in lacrimal gland carcinoma. Since the early 1990s, evidence has challenged the assumption that orbit-sacrificing surgery, including cranio-orbital resection and orbital exenteration, confers a survival advantage. This was subsequently reinforced by more contemporary long-term comparative outcome data demonstrating no significant survival benefit over globe-preserving surgery with radiotherapy. Recent findings in lacrimal gland adenoid cystic carcinoma are broadly consistent with this established evidence base, although comparisons with exenteration remain susceptible to treatment-selection bias.