Surgical Management of Malignant Eyelid Tumors: A Retrospective Analysis over 10 Years of Surgical Treatment in 1443 Consecutive Cases

Abstract: BACKGROUND: Malignant eyelid tumors are the most frequent malignant tumors in ophthalmology. They threaten the patients' vision and, if not treated adequately, even the patients' life. Complete resection of the tumor is the standard of care, but poses unique surgical challenges, due to the anatomical and functional importance of the eyelid region. Abstract: MATERIAL AND METHODS: We retrospectively analyzed data of 1,443 consecutive patients with malignant eyelid tumors who were treated at the Eye Center, Medical Center - University of Freiburg between 2009 and 2019. Data were collected on tumor type, post-excisional size of the lid defect, frequency of re-excisions and reconstructive effort regarding surgical duration and complexity. Reconstructive duration was categorized by the time required for eyelid reconstruction and the complexity of the reconstructive procedures, as based on the operation and procedure codes (OPS). Abstract: ). Re-excisions were most common in SGC (71%), then SCC and LM (both 53%). Regarding reconstruction duration, most patients (74%) required 30 - 90 minutes, with a minority needing less than 30 minutes (21%) or more than 90 minutes (5%). Reconstructive complexity was predominantly intermediate (54%), with 22% requiring low and 24% high reconstructive complexity. Abstract: CONCLUSIONS: The majority of malignant eyelid tumor reconstructions can be managed with surgical procedures that typically last between 30 and 90 minutes and have intermediate complexity, but surgeons must maintain expertise in complex reconstruction techniques for challenging cases.