A REVIEW OF 24 CASES OF MOHS SURGERY AND OPHTHALMIC PLASTIC RECONSTRUCTION

Purpose: Mohs surgery (micrographically controlled excision) has been advocated as an effective method of dealing with infiltrative periorbi tal skin tumours. It has been shown to have high rates of tumour clear ance with minimal loss of normal tissue, thus making oculoplastic reco nstruction easier and functional preservation better The aim of the pr esent study was to confirm this. Guidelines for the selection of patie nts for Mohs surgery are discussed. Methods: We retrospectively review ed 24 cases of primary (n=18) and recurrent (n=6) periorbital basal an d squamous cell carcinomas managed by Mohs micrographic excision and p lastic reconstruction who presented to the Royal Perth Hospital betwee n 1992 and 1996. Results: Our high rate of tumour clearance (100%) was similar to that of previous studies, although our follow-up period wa s only 14.6 months. The fact that 50% of our patients with lid involve ment had an intact posterior lamella after Mohs excision correlates wi th the high level of normal tissue preservation. The low rate of posto perative symptomatic problems suggests good maintenance of function. T he infiltrative nature of-these tumours was highlighted by the substan tial proportion of cases (37.5%) that had a much larger excision defec t than what was expected prior to excision. Conclusions: Our analysis confirms that Mohs excision and subsequent oculoplastic reconstruction is an effective method to use when managing periorbital infiltrative skin tumours.