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Diagnostic Biopsy of Iris Tumours with the Vitrectomy Cutter: Preliminary Results
1Anastassiou G., 1Schueler A., 2Dirsch O., 1Schilling H., 3Steuhl K. P., 4Bornfeld N.,
1Universität-Gesamthochschule Essen, Zentrum für Augenheilkunde (Essen)
2Universität-Gesamthochschule Essen, Institut für Pathologie (Essen)
3Universität-Gesamthochschule Essen, Zentrum für Augenheilkunde, Abt. für Erkrankungen des vorderen Augenabschnitts (Essen)
4Universität-Gesamthochschule Essen, Zentrum für Augenheilkunde, Abt. Hinterer Augenabschnitt (Essen)
Purpose: Tumours of the iris often present a diagnostic dilemma. In those cases a biopsy may be an alternative to clinical control. The most common procedure for biopsy is the iridectomy. Disadvantages of this method are the occurrence of a polycoria with monocular diplopia and the theoretical possibility of dissemination of malignant cells by the surgical manipulation. We present our initial experience with a novel method of biopsy.
Method: Twenty biopsies were performed with a standard vitrectomy cutter via a paracenthesis of the anterior chamber in 19 patients with suspected tumours of the iris. The biopsy material underwent cytological and/or histological examination.
Results: In 17 cases (85%) the material was sufficient for further examination. Cytology was performed in 15 cases (88.2%), whereas histology was possible in 6 biopsies (35.3%). An immunohistochemical examination was done in 3 cases (17.6%). In 13 out of 20 biopsies (65%) the result of the cyto-/histological examination was informative. The main complication during surgery was bleeding from the tumour (63.2%). Only in one case further surgical manipulation due to anterior chamber bleeding two days after the biopsy was necessary. A substantial defect of the iris did not occur in any case. The intraocular pressure raised to more than 30 mmHg in 6 patients at day 1 after the biopsy. Late onset side effects were not seen so far. The mean follow-up time is 7.3 months.
Conclusions: Biopsy of iris tumours with the vitrectomy cutter is a safe and gentle procedure. In the majority of the examined specimens (65%) the result of the cyto-/histological examination was informative and determined the further management of the patients.