A 5-year retrospective review of post-Mohs reconstruction outcomes for periocular cutaneous malignancies at an academic medical center.

Purpose: This project examines outcomes of post-Mohs reconstruction for periocular cutaneous malignancies. These results highlight reconstructive surgery challenges and their solutions, a topic with limited peer-reviewed literature. Methods: A retrospective chart review on post-Mohs reconstruction outcomes for adults seen at a tertiary referral center between August 2018 and March 2023 was performed. Information on demographics, past medical history, and surgical outcomes was collected. Descriptive statistics and correlations where applied were applicable. The Institutional Review Board (IRB) approved this study. Results: A total of 194 patients met the inclusion criteria (mean age, 67.7 years). Past medical history and skin cancer risk factors were evaluated. The most common periocular malignancy was basal cell carcinoma (70.6%), the location was lower lid (56.7%), and the reconstruction type was Modified Hughes tarsoconjunctival flap (24.7%). There were no intraoperative complications. The most common post-operative complications were healing issues (6.7%) or ectropion (6.2%). Patients reported post-operative symptoms such as eye irritation (23.2%) or pain (20.1%). Most patients had full eyelid function after surgery (93.3%) and acceptable cosmetic appearance (94.8%). Some correlations were found. For example, post-Mohs defect size was associated with variables such as cure rate (p = 0.01834) and general eyelid reconstruction (p = 0.0230). Adjuvant chemotherapy was associated with decreased cure rates (p = 0.0010) and recurrence (p = 0.0174). Conclusions: This study found associations between health history, periocular cutaneous malignancy features, and post-Mohs reconstruction outcomes. Features such as location, defect size, and staged reconstruction techniques in particular had an association with numerous outcomes.