Clinical Outcomes and Prognostic Factors in Eyelid Malignancy: A 17-Year Retrospective Analysis of Surgical Management and Reconstruction Techniques

Korean J Ophthalmol. 2024 Oct 22. doi: 10.3341/kjo.2024.0003. Online ahead of print.

Abstract

Purpose: To assess clinical outcomes in patients undergoing surgical excision and eyelid reconstruction for malignancies.

Methods: This 17-year retrospective study (2004-2021) analyzed patients with malignant eyelid tumors who underwent excision and reconstruction. Data on tumor type, size, location, surgical techniques, complications, and prognostic factors for recurrence were evaluated.

Result: A total of 152 patients underwent surgical excision and reconstruction for eyelid malignancies. Basal cell carcinoma (52.6%) was the most common, followed by sebaceous cell carcinoma (32.2%). Direct lid closure was the most frequent reconstructive method. Postoperative complications, including ectropion, entropion, and canalicular obstruction, were minimal but required additional surgery in some cases. Recurrence occurred in 13 patients. Lymph node involvement (OR 21.291, p = 0.004) and positive intraoperative frozen margins (OR 7.083, p = 0.018) were significant risk factors for local recurrence.

Conclusion: Surgical excision and reconstruction are effective treatments for eyelid malignancies, with techniques tailored to tumor size, location, and extension to ensure proper lid function. Lymph node involvement and positive intraoperative frozen margins are key predictors of local recurrence.

Keywords: eyelid malignancy; eyelid reconstruction; orbital exenteration; recurrence.