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Wei Gui, Ye Elaine Wang, Tara McCannel; Iris Biopsy Under Air: A Novel Technique for Biopsy of Suspicious Iris Lesions. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3644.
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© ARVO (1962-2015); The Authors (2016-present)
To report a novel technique for the biopsy of suspicious iris lesions under sterile air and to compare preliminary outcomes with a standard biopsy technique.
A retrospective study was conducted in patients who had a biopsy of suspicious iris lesions at Stein Eye Institute. A novel biopsy technique was performed with the operating microscope. Initially, a paracentesis is made and the anterior chamber (AC) is filled with sterile air through the paracentesis and then a fine needle is placed through the cornea either at the tumor or on the opposite side at the limbus to obtain the aspirate. The AC can be rinsed if a hyphema develops, and then refilled back with sterile air.
The study included 22 total patients with 13 patients who had a biopsy under air. The mean and standard deviation age of patients who underwent standard biopsy (standard group) and who underwent biopsy under air (air group) were 57±17 years and 51±19 years, respectively. 5 patients were male in both the standard group (55.6%) and in the air group (38.4%). Comparing the standard vs. air group, there was no statistically significant difference in mean logMAR visual acuity (VA) at presentation (0.13 vs. 0.053, p=0.19) or in intraocular pressure (IOP) in mmHg at presentation (23.2 vs. 17.5, p=0.88). In the standard vs. air group, there was also no statistically significant difference in the change in logMAR VA at post-operative day 1 (POD1, +1.54 vs. +1.74, p=0.28), at post-operative week 1 (POW1, +0.64 vs. +0.80, p=0.31), at post-operative month 1 (POM1, +0.26 vs. +0.53, p=0.15), or at post-operative month 3 (POM3, +0.11 vs. +0.20, p=0.26) or in the change in IOP in mmHg at POD1 (+3.14 vs. +3.36, p=0.49), at POW1 (-4.67 vs. -1.00, p=0.23), at POM1 (-3.62 vs. -1.57, p=0.37), or at POM3 (-8.62 vs. -3.80, p=0.20). Comparing the two groups, 2 patients (22.2%) in the standard group and 8 patients (61.5%) in the air group developed intraoperative hyphema, with a trend towards significance (p=0.099). There was no statistically significant difference in the proportion of patients with hyphema on post-operative day one (1/9 vs. 1/12, p=1.00).
We report a novel technique for the biopsy of suspicious iris lesions under sterile air. Preliminary results suggest that post-operative VA and IOP are comparable to a standard biopsy technique, yet biopsy under air may potentially reduce the presence of hyphema on post-operative day one.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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