Abstract

SA.17.01

Minimal invasive surgery for the treatment of malignant and semimalignant tumors of the eyelid

Peter Breil1, I. Tischoff2, H. Burkhard Dick1
1Universitäts-Augenklinik, Knappschaftskrankenhaus, Bochum; 2Institut für Pathologie an der Ruhr-Universität Bochum

Objective: Therapy of malignant and semimalignant (basal cell carcinoma) eyelid tumors often requires extreme surgical treatment with loss of function and aesthetic appearance.
Methods: In all cases malignant eyelid tumors initially were excised with a maximum of 10 mm distance to the tumor margin, following histopathological verification veryfied. All basal cell carcinomas were removed with only 1 mm distance to visible tumor margin. Second-look resection was performed with stripes smaller than 2 mm of lid margin in most cases. Plastic reconstruction was realized depending on defect size of the eyelid by readaption of the lid margin, free tarsokonjunctival grafts, skin-plastic or reconstruction of canthus.
Results: Since 3 years, only one local recurrence was observed in a patient with basal cell carcinoma. Postoperative en- or ectropium was not observed.
Conclusions: In surgical treatment of malignant and semimalignant eyelid tumors we recommend a sequential approach with maximum distance of 10 mm / 1 mm (malignant / basal cell carcinoma) to tumor margin for the initial excision. After the second excision of a pentagonal eyelid wedge and surgical reconstruction all patients demonstrated a satisfying functional and cosmetic outcome. Only one local recurrence was observed until now.

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