Post-Mohs reconstruction for periocular malignancies shows low complication rates in retrospective review

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Frontiers in Medicine Published April 28, 2026 Medically reviewed April 28, 2026 DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Consider that post-Mohs reconstruction for periocular malignancies had low complication rates in this retrospective review.

This retrospective cohort review analyzed 194 adults seen at an academic tertiary referral center for post-Mohs reconstruction of periocular cutaneous malignancies, including basal cell carcinoma. The study assessed reconstructive surgery outcomes, complications, and symptoms, with no reported comparator group.

The most common post-operative complications were healing issues (6.7%) and ectropion (6.2%). Patients reported eye irritation (23.2%) and pain (20.1%). Most patients had full eyelid function (93.3%) and acceptable cosmetic appearance (94.8%).

Associations were noted between post-Mohs defect size and 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). No intraoperative complications were reported.

Key limitations include the retrospective design, single-center setting, and limited peer-reviewed literature on the topic. Follow-up duration was not reported. Findings are based on chart review, and correlations may not imply causality.

Practice relevance highlights reconstructive surgery challenges and solutions for periocular malignancies, but results may not generalize beyond this population.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

PurposeThis 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.MethodsA 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.ResultsA 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).ConclusionsThis 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.