Outcomes of Mohs micrographic surgery for periocular squamous cell carcinoma

Introduction: Periocular cutaneous squamous cell carcinoma (cSCC) accounts for 5-10% of all eyelid malignancies. Periocular cSCC carries a low mortality rate but can be destructive to local tissues. Due to the unique function and anatomy of the eyelids, Mohs micrographic surgery (MMS) is gold standard for treating cSCC to preserve healthy tissue and reduce rates of local recurrence. In this study, we describe the success and outcomes of MMS and subsequent oculoplastic reconstruction for periocular cSCC in the North East of England. Methods: Retrospective analysis of 34 patients who underwent MMS for periocular cSCC in the North of England between 2013 and 2020. Primary outcome measure of success is defined as no recurrence of cSCC after minimum 24 months' time elapsed post-MMS. Secondary outcome measures included analysis of disease characteristics, describing the surgical techniques utilised for oculoplastic reconstruction following MMS and surgical complications should they occur. Results: Two patients (5.9%) had local recurrence of periocular cSCC. Median time elapsed since MMS was 60 months. A variety of oculoplastic surgical techniques were utilised in the repair of the Mohs defect. One patient (2.9%) developed a significant post-operative reconstruction complication. Conclusion: Periocular cSCC recurrence following MMS in the North of England is 5.9%, which is comparable to the literature. Significant post-operative complications following oculoplastic reconstruction of periocular MMS are very low, occurring in 2.9% of cases in this study.