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Vasileios Petousis, Paul T. Finger, Tatyana Milman; Iris and Iridociliary Tumor Biopsy Utilizing a 25-Gauge Aspiration-Cutter: 10-year Experience. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3271.
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To demonstrate the results and complications of an aspiration-cutter assisted biopsy and compare them to those of other techniques.
Retrospective, single-center study of 50 consecutive patients (50 eyes) who underwent biopsy between 2000 and 2010. This is an one entry-point, clear corneal incision followed by viscoelastic chamber maintenance and 25-gauge aspiration cutter biopsy. Indications included: atypical tumor and the patient’s request for a pathology diagnosis in cases of iris or iridociliary tumors. Data was obtained through chart review. Assessed outcomes included: visual acuity, secondary cataract and glaucoma, hemorrhage and recurrence.
The median follow-up was 31 months (range: 7-190 months). The mean patient age was 61 years (median: 61 years, range: 33 - 88 years). The mean initial visual acuity was 20/50 (median: 20/20, range: 5/200 - 20/20). The majority were either nodular iris tumors (54%) or iridociliary tumors (42%) while there was also one multifocal (2%) and one diffuse lesion (2%). Seven cases (n=7/50, 14%) required one 10-0 nylon suture to close the corneal entry point. Pre-operative pigment dispersion (4%) was rare. Most cases were found to be iris melanoma (72%) followed by iris nevus (6%) and melanocytoma (6%). Short-term, peri-operative surgical findings included transient increase of intraocular pressure (n=6/50, 12%) and one case of hyphema (2%), flare (2%) and pupillary defect (2%). All but two pupillary defects resolved within 4 weeks of the biopsy procedure. There were no secondary cataracts or infections.
An adequate specimen was acquired in 100% of cases. There have been no short or long-term complications related to use of a 25-gauge aspiration cutter. Aspiration-cutter assisted anterior segment biopsy technique is a safe and effective procedure for biopsy of iris and iridociliary tumors.
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