Purpose: To determine the clinical presentation of and evaluate the complications following reconstructive surgery for sebaceous carcinoma of the eyelid.
Patients and methods: A retrospective evaluation was performed in 55 patients with sebaceous carcinoma of the eyelid who underwent tumor resection and reconstruction between September 2004 and June 2018 (mean postoperative observation period: 3.6 years) at the Department of Ophthalmology, Kyoto Prefectural University of Medicine to assess clinical presentations and postoperative complications after reconstruction.
Results: Of all 55 patients, 25 were male and 30 were female, with a male-to-female ratio of 5: 6. The mean age±standard deviation was 74±14 years, and 52 had nodular type, and 3 had diffuse type disease. Reconstructive procedures performed included a Tenzel flap in 12 patients (22%), switch flap in 5 (9%), free tarsal graft in 8 (15%), Hughes flap in 14 (25%), hard palate mucosa graft in 15 (27 %), and orbital exenteration in 1 patient (2%). Complications requiring repeat surgery were observed in 18 patients (32%), including 8 patients experiencing inversion, 6 experiencing lagophthalmia, 5 experiencing ptosis, and 1 experiencing lateral canthal repositioning. When assessed via surgical procedure, the most frequently occurring complications(10 patients)were observed in those who underwent hard palate mucosa grafts. Recurrence occurred in 9% and metastases in 13%.
Conclusions: Few differences were noted between male and female Japanese patients for sebaceous carcinoma of the eyelid, and the percentage of diffuse type disease was lower. The frequency of postoperative complications was shown to be lower with posterior lamellar reconstruction using flaps (Hughes flap) or full-thickness eyelid (Tenzel flap, Switch flap) than with free posterior lamellar grafts such as free tarsal grafts and hard palate mucosa grafts.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 410-416, 2020.