Microincision, aspiration cutter-assisted multifocal iris biopsy for melanoma

Paul T. Finger, Tatyana Milman

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Purpose: To describe a minimally invasive method to create multifocal full-thickness surgical iridectomy biopsies. Methods: Seven patients suspected to have diffuse iris melanoma underwent multifocal surgical iridectomy biopsy through a single 1.0-mm clear corneal incision. A 25-G inked trocar was used to create one visible corneal portal, through which the anterior chamber was filled with sodium hyaluronate 1%. Then, a 25-G aspiration cutter probe was introduced through the corneal incision such that the aspiration portal was occluded by the iris biopsy sites. Then aspiration (600 mm Hg) cutting (300 cuts per minute) was used to create full- and partial-thickness surgical iridectomy biopsies at multiple locations. After each biopsy the probe was removed, and its contents aspirated into a separate 3-mL syringe (marked by clock hour location). The sodium hyaluronate 1% was removed and wound checked for leakage. Results: Diagnostic specimens were obtained in all cases. Five were found to be diffuse iris melanomas and 2 were indeterminate iris melanocytic proliferations. No patients developed a secondary increase in intraocular pressure, hyphema, infection, cataract, or vision loss. No cases of intraocular tumor dissemination were observed. No patient complained of glare or monocular diplopia. Three of 7 corneal wounds were self-sealing. Conclusions: Multifocal surgical iridectomy biopsy can be minimally invasive and effective allowing for partialand full-thickness iris biopsy. Use of a 25-G aspiration cutting probe allowed for small incision surgery, rapid rehabilitation, and no significant complications.

Original languageEnglish
Pages (from-to)62-66
Number of pages5
JournalEuropean Journal of Ophthalmology
Volume27
Issue number1
DOIs
StatePublished - 1 Jan 2017
Externally publishedYes

Keywords

  • Anterior segment
  • Iridectomy
  • Iris
  • Melanoma
  • Multifocal
  • Small incision

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