Abstract
Abstract: :
Purpose: To develop a minimally invasive technique for iris biopsy, iridectomy and tumor excision. Methods: Nine consecutive patients with anterior segment tumors were included in this study. FIT involved introduction of a 25–gauge aspiration–cutter probe through a 1 mm clear corneal, self–sealing incision. Prior to insertion, the anterior chamber was prepared with acetylcholine chloride 10 mg/ml and sodium hyaluronate 1%. Aspiration (mean 300 mm/Hg) cutting (mean 300 cpm) was performed to obtain specimens for cytology, iridectomy and tumor excision. Results:No patient suffered post–operative hyphema, infection or loss of vision. No patient required a suture to close the small corneal wound. No patient lost 1 or more lines of visual acuity. As a result of the FIT procedure, diagnostic material was obtained in (8/9) 88% of cases. Diagnoses included: normal iris stroma (1), iris nevus (1), melanocytoma (1), sarcoid granuloma (1), epithelial inclusion cyst (1) and 4 cases of malignant melanoma. The sarcoid granuloma failed to be aspirated by the FIT. These diagnoses resulted in the use of observation (3), palladium–103 plaque radiation therapy (2), FIT–iridectomy (2), FIT–cystectomy (1) and oral steroid therapy (1). Conclusions: The Finger Iridectomy Technique (FIT) was minimally invasive and very effective. Aspiration cutting yielded relatively large pieces of tissue (and cells) that were used for cytopathologic and histopathologic evaluation. Small incision surgery allowed for rapid rehabilitation and no significant complications.
Keywords: oncology • cytology • iris