Mohs Micrographic Surgery of the Eyelid: An Overview of Anatomy, Pathophysiology, and Reconstruction Options

• Published in: Dermatologic surgery 2013-05, Vol.39 (5), p.673-697
• Main Authors: Harvey, David T., Taylor, R. Stan, Itani, Kamel M., Loewinger, Robert J.
• Format: Article
• Language: English
• Subjects: Carcinoma, Basal Cell - surgery; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Eyelid Neoplasms - pathology; Eyelid Neoplasms - physiopathology; Eyelid Neoplasms - surgery; Eyelids - anatomy & histology; Eyelids - innervation; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Humans; Mohs Surgery; Oculomotor Muscles - anatomy & histology; Reconstructive Surgical Procedures - methods; Sebaceous Gland Neoplasms - pathology; Sebaceous Gland Neoplasms - surgery; Skin Neoplasms - pathology; Skin Neoplasms - physiopathology; Skin Neoplasms - surgery; Squamous Cell Carcinoma of Head and Neck; Surgical Flaps
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1111/dsu.12084

Background Mohs micrographic surgery (MMS) is the ideal treatment for skin cancer removal. The advantages of MMS in the eyelid area include its high cure rate, tissue‐sparing effects, and overall cost effectiveness. Objective To review eyelid anatomy, detail ocular tumors that are amenable to MMS, and examine the surgical repair options commonly used in this area. Materials and methods A review of the literature on MMS of the eyelid was performed with specific reference to ocular anatomy, eyelid malignancy types, and surgical reconstruction. Conclusion Eyelid function is critical for the maintenance of ocular health and vision. MMS is an ideal skin cancer treatment for the delicate structure of the eyelid, where maximal tissue preservation is critical. There are a plethora of reconstruction options to consider after MMS has been performed in this area. The choice of repair and surgical outcome depend, in part, on the surgeon's knowledge of eyelid anatomy and his or her ability to assess the repair requirements of the post‐MMS defect. Dermatologic surgeons can effectively work with other specialists to help ensure that their patients receive a cure with restored ocular function and optimal cosmesis.