Abstract: Objective To study therapy and the risk factors for ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma transformation into diffuse large B cell lymphoma (DLBCL) so as to find suitable operation to reduce the incidence of postoperative complications as well as to improve the survival rate of patients. Design Retrospective case series. Participants 79 patients with biopsy-proven ocular adnexal MALT lymphoma in Changzheng hospital affiliated to Second Military Medical University from January 1997 to June 2010. Methods The clinical features, therapy (including surgery and radiation therapy) and prognosis of 79 patients were retrospectively reviewed. Surgery included complete excision and partial excision. Prognosis including survival rate and the risk factors for transformation to DLBCL was assessed.　Main Outcome Measures The clinical features, surgery therapy, radiation therapy, survival rate, the risk factors for transformation to DLBCL. Results All cases were treated by operation. Fifty eight cases were treated with complete excision tumorectomy, while 21 cases with partial excision. All the patients received local radiotherapy on the eyes. There were 6 cases transformed from ocular adnexal MALT lymphoma into DLBCL. Radiotherapy was found to be benefitial for the controlling local symptoms of ocular adnexal MALT lymphoma. Bilateral onset （P=0.0221） and the initial reaction to radiotherapy （P=0.0033） were found to be correlated with the transformation from ocular adnexal MALT lymphoma into DLBCL. Nonetheless, gender, age, locations, tumor size and surgical procedures had no effects on the transformation. Conclusions Bilateral onset and the initial reaction to radiotherapy are correlated with the transformation from ocular adnexal MALT lymphoma into DLBCL. Nonetheless surgical procedures are of no effect on the transformation. However, selecting a suitable operation could reduce the incidence of postoperative complications. （Ophthalmol CHN, 2012, 21: 352-356）

Key words: ocular adnexa, mucosa-associated lymphoid tissue, lymphoma, diffuse large B cell lymphoma