Minimally invasive anterior orbitotomy biopsy: Finger's aspiration cutter technique (FACT)

Purpose. To evaluate aspiration cutter-assisted small-incision anterior orbitotomy. Methods. Three patients with orbital adnexal tumors underwent orbital biopsy through a 3-mm incision in the eyelid skin (n=2) or conjunctival fornix (n=1). Standard aspiration cutters were introduced into anterior and posterior orbital tumors utilizing a bimanual technique. Multiple passes were made into the tumor. Fresh specimens were analyzed for adequacy prior to the end of surgery. Cytopathology, histopathology, and immunohistochemical analysis were performed. Results. Aspiration cutter technique biopsies were diagnostic in 2 of 3 cases. Diagnoses were orbital lymphoma, metastatic endometrial adenocarcinoma, and metastatic prostate cancer. The 20-G aspiration cutter yielded the most tissue. No sutures were required for the small incisions. Conclusions. Sutureless, aspiration cutter biopsy offered benefits commonly associated with fine needle aspiration biopsy, controlled aspiration, and enclosed mechanical cutting.