Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.
Ophthalmic Plast Reconstr Surg. 2019 Nov/Dec;35(6):604-608. doi: 10.1097/IOP.0000000000001421.
To evaluate the relationship between pre-Mohs skin cancer lesion measurements with the post-Mohs defect size in order to most accurately estimate post-Mohs defect size.
This is a retrospective analysis of patients who underwent Mohs excision by one of 3 Mohs surgeons followed by reconstruction for basal cell carcinoma or squamous cell carcinoma of the eyelid. The study included all patients from January 2011 to May 2018 operated on by a single oculoplastic surgeon (R.M.) at the University of Texas Southwestern Medical Center. Maximum horizontal and vertical (H/V) dimensions were determined clinically by Mohs surgeons at the time of excision and photographs of the lesion and defect size were analyzed in order to determine the total area of the lesion preoperatively and the defect postoperatively with Image J using H/V dimensions and the area tracing function.
Forty-two patients with periocular skin cancers underwent Mohs resection followed by reconstruction. The Mohs defect was overall 4.88 times the size of the preoperative skin cancer measurement using maximum H/V dimensions by Mohs surgeons (p < 0.0001). When using Image J, the area of the Mohs defect was 6.5 times the size of the preoperative lesion (p < 0.0001) using both the maximum H/V dimensions and the area tracing function. There was a statistically significant difference between the Image J area tracing and area determined with H/V dimensions by both the Mohs surgeon and Image J.
Postoperative Mohs defect size can be estimated based on maximum H/V dimensions clinically or with Image J technology. Image J digital photograph analysis using the area tracing function more accurately determines the pre-Mohs lesion size and the post-Mohs defect area when compared with standard maximum H/V measurements and digital photographic analysis of maximum H/V measurements with Image J.The preoperative periocular skin cancer measurements can assist in determining the post-Mohs defect size.
评估术前皮肤癌病变测量值与 Mohs 术后缺陷大小之间的关系，以便更准确地估计 Mohs 术后缺陷大小。
这是对由 3 名 Mohs 外科医生中的 1 名进行 Mohs 切除术并随后对眼睑基底细胞癌或鳞状细胞癌进行重建的患者进行的回顾性分析。该研究包括 2011 年 1 月至 2018 年 5 月期间由德克萨斯大学西南医学中心的一位眼整形外科医生（R.M.）进行手术的所有患者。Mohs 外科医生在切除时通过临床确定最大水平和垂直（H/V）尺寸，并分析病变和缺陷大小的照片，以使用 H/V 尺寸和面积跟踪功能在术前确定病变的总区域和术后缺陷的区域。
42 例眼部皮肤癌患者接受了 Mohs 切除术和重建。Mohs 缺陷总体上是 Mohs 外科医生使用最大 H/V 尺寸测量的术前皮肤癌测量值的 4.88 倍（p<0.0001）。当使用 Image J 时，Mohs 缺陷的面积是术前病变的 6.5 倍（p<0.0001），使用最大 H/V 尺寸和面积跟踪功能。Mohs 外科医生和 Image J 用最大 H/V 尺寸确定的 Mohs 缺陷的面积与 Image J 面积跟踪之间存在统计学显著差异。
Mohs 术后缺陷大小可以基于临床最大 H/V 尺寸或使用 Image J 技术进行估计。与标准最大 H/V 测量值和使用 Image J 对最大 H/V 测量值的数字照片分析的最大 H/V 测量值相比，Image J 数字照片分析使用面积跟踪功能更准确地确定术前眼部皮肤癌病变大小和 Mohs 术后缺陷区域。术前眼部皮肤癌测量值有助于确定 Mohs 术后缺陷大小。
