Micrographic surgery for the microscopically controlled excision of eyelid cancer: history and development.

The development of a method for the total microscopic control of excising external cancer began with the concept of first excising the affected tissues in successive layers and then using frozen sections for the systematic microscopic scanning of the entire undersurface of each layer. This method permitted the precise detection and selective removal of "silent" cancerous ramifications and obviated the need to sacrifice a margin of normal-appearing tissue. The reliability of the method for treating eyelid cancers is manifested by high 5-year cure rates of 98% for basal cell carcinoma and 98.1% for squamous cell carcinoma. The maximal conservation of normal tissues simplifies any needed repairs and permits some innovative ways of managing wounds with healing by granulation and by partial closures with guiding sutures.