Br J Ophthalmol 91:794-796 doi:10.1136/bjo.2006.109892
  • Surgical techniques

Confident complete excision of lid-margin BCCs using a marginal strip: an alternative to Mohs’ surgery

  1. Narendra Dhingra1,
  2. Adam Gajdasty1,
  3. Jim W Neal2,
  4. Achyut N Mukherjee1,
  5. Carol M Lane1
  1. 1Cardiff Eye Unit, University Hospital of Wales, Cardiff, UK
  2. 2Department of Histopathology, University Hospital of Wales, Cardiff, UK
  1. Correspondence to: MrN Dhingra Cardiff Eye Unit, University Hospital of Wales, Cardiff CF14 4XW, UK; ndhingra{at}
  • Accepted 3 January 2007
  • Published Online First 17 January 2007


Aims: To report a new technique of tissue preparation, using a marginal strip, after the excision of eyelid basal cell carcinomas (BCCs) and to report the long-term results of BCCs excised using this technique.

Method: After the excision of eyelid BCC with a safety margin of 4 mm, a 1 mm strip was excised along the whole perimeter from the margin of the freshly excised specimen. This marginal strip had intact conjunctival mucosa along one edge and skin along the other. The marginal strip and the central tumour mass were then fixed immediately in formal saline and subjected to conventional histopathology.

Results: Of the 61 patients who completed a 5 years follow-up, the results of 28 eye-lid BCCs that were within 4 mm of the lid margin are reported. The marginal strip was clear in 22 specimens and had the presence of residual tumour in its margin in 6 specimens. These six 6 cases were further managed by observation (n = 2), by further surgical excision using marginal strip (n = 2) and by Mohs’ surgery (n = 2).

Conclusion: Marginal strip examines the entire resection margins analogous to Mohs’ technique and we recommend its use in lid margin where tarsus is present throughout the specimen and >4 mm from the lid margin.


  • Competing interests: None declared.

  • Published Online First 17 January 2007

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