Leaving the eyelid to its own devices.

As oculoplastic surgery is preferred for direct closure of lid defects, spontaneous wound healing after excision of lid tumors is not common. Thus, spontaneous reformation of lid defects as an alternative treatment to surgical procedures was investigated. In 12 patients with a clinical diagnosis of basal-cell carcinoma, lid tumors were removed surgically by full-thickness excision in 1 group (n = 6) or cutaneous excision only in the other group (n = 6). The mean follow-up period was 5 months in the first group and 9 months in the second group. Cosmetic and functional results were satisfactory in all patients. The scar tissue simulated the former tarsus. The wounds were completely covered by a normal-appearing epithelium. Spontaneous wound healing may lead to considerable stiffness of the lower lid and to an acceptable reformation of the lid margin. There was no elevation of the lid margin and, remarkably, no secondary surgery due to an entropion or an ectropion was necessary.