Document Type

Article

Publication Date

10-3-2026

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This article is the author's final published version in AJO International, Volume 3, Issue 3, October 2026, Article Number 100285.

The published version is available at https://doi.org/10.1016/j.ajoint.2026.100285. Copyright © The Authors.

Abstract

Objective: To evaluate and compare epidemiology, clinical and histopathologic features, and outcomes of conjunctival papilloma in historical and modern cohorts. Design: Retrospective comparative cohort study. Participants: Patients with conjunctival papilloma at a tertiary referral center between 2015 and 2024. Methods: A retrospective review of Oncology and Pathology records was conducted to identify all patients with conjunctival papilloma over a 10-year period (2015–2024). Data collected included demographics, HPV vaccination status, clinical tumor characteristics, treatment modalities, outcomes, and histopathologic findings of excised lesions. Patients were stratified by age (≤20 vs.> 20 years). Findings were compared with a historical cohort managed at the same institution (1970–2012). Results: Fifty-six conjunctival lesions were identified in 40 patients (mean age, 50 years; range, 8–89). Those older than 20-years-old demonstrated thicker tumors (4.6 vs. 2.2 mm, p = 0.03) with a predilection for the fornix (36%vs 0%; p = 0.02), whereas younger patients more commonly had bulbar lesions (46%vs 13%; p = 0.03). There was no difference in configuration (sessile vs. pedunculated, p > 0.99) between the age groups. The most common primary treatments included excision with cryotherapy (38%) or excision with cryotherapy plus interferon alfa-2b (38%). A combination of excision, cryotherapy and adjuvant oral cimetidine and interferon alfa-2b was significantly more common in the children and adolescent cohort compared to adults (56%vs. 0%, p < 0.01). Three tumors (9%) recurred following treatment. None of the lesions underwent malignant transformation. Compared with the historical cohort, patients in this study were older (mean 50 vs 43 years, p = 0.04), with a higher proportion of diffuse lesions (14%vs 3%, p < 0.01). Historically, most papillomas were treated with excision and cryotherapy alone (62%vs. 38%, p < 0.01), whereas, in our modern cohort there was a significantly increased use of excision and cryotherapy with adjuvant interferon alfa-2b (38%vs. 18%, p < 0.001). Conclusion: This study demonstrates evolving demographic, clinical characteristics, and treatment trends in conjunctival papilloma over the past decade, including a shift toward an older patient population. Despite these changes, treatment outcomes remain favorable.

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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Language

English

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Available for download on Saturday, October 03, 2026

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