Moh's excision for morphea form  of basal cell carcinoma This 42 year-old woman had had Moh's excision for a morphea form of basal cell carcinoma in the left lower lid by the dermatologist. The medial two third of the lower lid margin was removed including 2 mm in height of the tarsal plate, the lacrimal punctum and canaliculus. There was no corneal exposure and the lid closure was normal.  To reconstruct the lower lid defect, a Hughes' flap would be less disfiguring than cheek rotational flap. However, after going through the pro and cons with the patient, it was decided to delay the reconstruction and allowed the lower lid to granulate spontaneously (laissez-faire) before further decision. In oculoplastic surgery, it is sometimes tempting to perform elaborate surgery for lid defects. However, the results of such surgery may leave the patients with more disfigurement than the defect itself.

Primary position

Up-gaze

Lid closure

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