Surgical Excision and Reconstruction of Primary Basal Cell Carcinoma (PBCC) of Eyelid (Clinical Control Excision Method)

Abstract

 Purpose: To evaluate the patients with PBCC of eye lid and to demonstrate outcome of clinically controlled tumor excision method and to correct significant functional and cosmetic blemish.

Material and Methods: This study was conducted in the department of ophthalmology, Chandka Medical College Hospital, Larkana from Sept. 2001 to Feb.’ 2008. In this study evaluation of 24 patients of 45 years to 80 years old with histological diagnosis of PBCC involving the eye lid and/or its margins was done. All patients under went with tumor excision and immediate reconstruction using clinical control excision method with the operating biomicroscope under local anaesthesia. The surgical procedures used were selected by on the size & location of the tumor. Postoperative follow up examinations were carried out at 1st week then after at 1, 3, 6 and 12 months, later on annually for a further 5 years and longer. Tumors location, size, type, recurrence and postoperative complications were evaluated.

Results: The primary tumor location was on the lower lid 10 (41.66%) cases, upper lid 7 (29.16%) cases, medial canthus 4 (16.66%) cases and lateral canthus 3 (12.50%) cases. The size of tumors at presentation was, tumor involving 1/4 of the eye lid 2 (8.33%) cases, 1/3 of lid 6 (25.00%) cases, 1/2 of lid 6 (25.00%) cases, 2/3 or more of lid in 3 (12.50%) cases, 1/4 medial canthus 4 (16.66%) cases and 1/4 lateral canthus 3 (12.50%) cases. The type of the tumor was nodulo ulcerative in 15 (62.50%) cases, sclerosing 5 (20.83%) cases and superficial multicentric 4 (16.66%) cases. The recurrence of the tumor was noticed in 3 (12.50%) cases.

Conclusion: Early presentation of patient in the initial stage of the tumor will allow simple primary wound closure with less functional tissue loss and this also resulted in decreased risk of tumor recurrence and cosmetic blemish.