Cryosurgery of eyelid basal cell carcinomas including 781 cases treated over 30 years

Abstract

PURPOSE: To present the results of a 30-year prospective study in which eyelid basal cell carcinomas were treated with cryosurgery. METHODS: Basal cell carcinomas with well-defined borders on the eyelids or medial canthus, diagnosed by punch biopsy, were included. Cryosurgery was performed using liquid nitrogen sprayed into a cone circumscribing the tumours. The tumours were treated in a double freeze-thaw cycles technique. The minimum thawing time of the frozen area outside the tumour margin was at least 60 seconds. During the first 20 years of the study, patients were re-examined for up to 10 years. In the last 10 years of the study, most patients were followed up for 1 year, and if there was no visible scarring in the treated area at the 1-year check-up, follow-ups were implemented at the patient's request following self-assessment. RESULTS: In total, 781 tumours in 768 patients were treated. The median age of the patients at treatment was 73 years, mean 70.9 years (range 22-102 years). More women (58%) were treated than men. The median tumour size was 8 mm, mean 9.1 mm (range 2-25 mm). There were few side-effects requiring intervention. Twelve patients underwent surgery due to ektropion during follow-up. In 101 patients, treatment of the tumour resulted in conjunctival growth on the skin side, which required correcting operations in 28 patients. Three recurrences have occurred. CONCLUSION: Cryosurgery is an effective treatment modality for eyelid basal cell carcinomas, resulting in few recurrences and good cosmetic and functional outcomes at a low cost.