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A reappraisal of cryosurgery for eyelid basal cell carcinomas.
Br J Ophthalmol. 2002 Apr; 86(4):453-7.BJ

Abstract

BACKGROUND/AIMS

Liquid nitrogen spray freezing has been successfully applied for basal cell carcinomas in the eyelid region, but is not yet in general use. The reasons for this were analysed and the development of a more reliable, safer cryosurgical technique aimed for.

METHODS

New cryosurgical apparatus, contact probes with increased freezing power, and a special application technique were developed and clinically tested in a consecutive series of 221 patients with primary basal cell carcinomas of the lid region. Special efforts yielded follow up reports of 220 out of the 221 patients.

RESULTS

Experimental measurements and clinical results demonstrated that this cryosurgical technique was at least as effective as spray freezing, with lower risks. The rate of recurrent tumours in patients followed up for 5 years or longer was 5.1% (surgeons first result) respectively 0.6% (result after optimised second cryosurgery). The figures were 6.8%, respectively max 2.7%, when including all patients, independent of follow up time.

CONCLUSION

Traditional surgery and histopathology, still used at numerous places, resulted in higher recurrence rates despite extended loss of healthy eyelid tissues and should be abandoned. Micrographic surgery is considered mandatory to save more of the healthy structures and to obtain lower recurrence rates. Cost and time require worldwide restriction of micrographic surgery to selected cases. Updated cryosurgery provides a low cost option to micrographic surgery and results in preservation of eyelid structures and lacrimal pathways, tarsal plate, lid margin. It provides excellent cosmetic results. Thus, primary basal cell carcinomas in the eyelid region of suitable size and location should receive updated cryosurgery, and tumours beyond its range micrographic surgery.

Authors+Show Affiliations

University Eye Hospital Wuerzburg, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11914217

Citation

Buschmann, W. "A Reappraisal of Cryosurgery for Eyelid Basal Cell Carcinomas." The British Journal of Ophthalmology, vol. 86, no. 4, 2002, pp. 453-7.
Buschmann W. A reappraisal of cryosurgery for eyelid basal cell carcinomas. Br J Ophthalmol. 2002;86(4):453-7.
Buschmann, W. (2002). A reappraisal of cryosurgery for eyelid basal cell carcinomas. The British Journal of Ophthalmology, 86(4), 453-7.
Buschmann W. A Reappraisal of Cryosurgery for Eyelid Basal Cell Carcinomas. Br J Ophthalmol. 2002;86(4):453-7. PubMed PMID: 11914217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A reappraisal of cryosurgery for eyelid basal cell carcinomas. A1 - Buschmann,W, PY - 2002/3/27/pubmed PY - 2002/5/25/medline PY - 2002/3/27/entrez SP - 453 EP - 7 JF - The British journal of ophthalmology JO - Br J Ophthalmol VL - 86 IS - 4 N2 - BACKGROUND/AIMS: Liquid nitrogen spray freezing has been successfully applied for basal cell carcinomas in the eyelid region, but is not yet in general use. The reasons for this were analysed and the development of a more reliable, safer cryosurgical technique aimed for. METHODS: New cryosurgical apparatus, contact probes with increased freezing power, and a special application technique were developed and clinically tested in a consecutive series of 221 patients with primary basal cell carcinomas of the lid region. Special efforts yielded follow up reports of 220 out of the 221 patients. RESULTS: Experimental measurements and clinical results demonstrated that this cryosurgical technique was at least as effective as spray freezing, with lower risks. The rate of recurrent tumours in patients followed up for 5 years or longer was 5.1% (surgeons first result) respectively 0.6% (result after optimised second cryosurgery). The figures were 6.8%, respectively max 2.7%, when including all patients, independent of follow up time. CONCLUSION: Traditional surgery and histopathology, still used at numerous places, resulted in higher recurrence rates despite extended loss of healthy eyelid tissues and should be abandoned. Micrographic surgery is considered mandatory to save more of the healthy structures and to obtain lower recurrence rates. Cost and time require worldwide restriction of micrographic surgery to selected cases. Updated cryosurgery provides a low cost option to micrographic surgery and results in preservation of eyelid structures and lacrimal pathways, tarsal plate, lid margin. It provides excellent cosmetic results. Thus, primary basal cell carcinomas in the eyelid region of suitable size and location should receive updated cryosurgery, and tumours beyond its range micrographic surgery. SN - 0007-1161 UR - https://www.unboundmedicine.com/medline/citation/11914217/A_reappraisal_of_cryosurgery_for_eyelid_basal_cell_carcinomas_ L2 - https://bjo.bmj.com/lookup/pmidlookup?view=long&pmid=11914217 DB - PRIME DP - Unbound Medicine ER -