Use of Eye Shields for Mohs Micrographic Surgery of the Eyelids and Periorbital Area

BACKGROUND Internal eye shields are designed for use in periorbital procedures, but their use in Mohs micrographic surgery (MMS) of the eyelids has rarely been reported in the literature. OBJECTIVE The authors aim to discuss different types of internal eye shields as well as their indication, proper use, and potential complications. MATERIALS AND METHODS The authors performed a literature search on PubMed with the keywords "internal eye shield," "corneal shield," "scleral shield," and "periorbital Mohs micrographic surgery" with no restriction on publication time frame due to the scarcity of relevant literature. RESULTS Experts seem to agree that use of eye shield for MMS of the eyelids is a reasonable measure to undertake to prevent operative injuries. Although either plastic or stainless steel eye shield can be used, plastic eye shields are often preferred and recommended in procedures where electrosurgical devices need to be used. CONCLUSION Although the authors recommend the use of internal eye shields for MMS of the eyelids for preventing operative injuries, this recommendation (Grade C) is based on very limited evidence (Level 5). More research and higher-powered studies are needed for conclusive evidence and to establish clear guidelines for providers.

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