Management of periocular actinic keratosis: a review of practice patterns among ophthalmic plastic surgeons.

[PURPOSE] To determine the practice patterns of ophthalmic plastic surgeons regarding the management of actinic keratosis (AK) of the eyelid and periocular area.

[METHODS] A brief electronic survey was distributed to members of the American Society of Ophthalmic Plastic and Reconstructive Surgery requesting their demographic information and treatment approaches to AK.

[RESULTS] One hundred and seven of 523 (20.5%) American Society of Ophthalmic Plastic and Reconstructive Surgery members completed the survey. Most respondents treat AK < 2 mm from the eyelid margin by excision with permanent pathology (62.6%), followed by referral for Mohs excision (10.3%) and excision with frozen section control (9.3%). Similar responses were recorded for the treatment of AK > 2 mm from the eyelid margin, with most respondents treating by excision with permanent pathology (56.1%), followed by referral to dermatology for Mohs or non-Mohs treatment and topical chemotherapy (8.4% each).

[CONCLUSION] Although most American Society of Ophthalmic Plastic and Reconstructive Surgery members use excisional biopsy with permanent section pathology control of margins for the treatment of AK of the eyelid and periocular region, multiple alternative treatment approaches are also used.