title: Small incision iris tumour biopsy using a cavernous sampling forceps.
abstract: BACKGROUND
  The aim of this retrospective report is to describe our experience with the Essen-23G biopsy forceps (Akgül forceps) for biopsies of pigmented iris tumours.
  
  
  METHODS
  In this retrospective study of cases between October 2012 and September 2013, patients with iris tumours and clinical signs for malignancy underwent biopsy to secure the diagnosis. The Essen-23G-forceps was used to grasp and extract tissue through a clear corneal incision. Eventual entry and bimanual manipulation with a 23G mini-scissors was achieved through a second incision. Tissue samples were fixed in a sterile tube for further histopathological and immunohistochemical evaluation.
  
  
  RESULTS
  Seven eyes of seven patients underwent biopsy using the forceps. The average thickness of the iris tumours was 1.07±0.79 mm. A second corneal incision for scissoring in a bimanual technique was necessary in 5 cases (71%). In 6 cases (85%), a precise histological and immunohistochemical diagnosis was achieved. Complications were limited to minute bleeding at the biopsy site and one case of relative pupil enlargement (anisocoria) without further refractive issues.
  
  
  CONCLUSIONS
  Iris tumour biopsies can be successfully approached using a cavernous 23G intraocular forceps with a low risk for procedure-related complications. The conical interior design allows for removal of whole tissue pieces with minimal manipulative artefacts. An optional bimanual access through a second corneal incision and use of a 23G scissors provides better efficacy.
authors: Depatment of Ophthalmology, Charité University Medicine Berlin, Berlin, Germany Institute for Pathology, Charité University Medicine Berlin, Berlin, Germany.
authors: Argyrios
authors: A
authors: Chronopoulos
authors: Depatment of Ophthalmology, Charité University Medicine Berlin, Berlin, Germany Institute for Pathology, Charité University Medicine Berlin, Berlin, Germany.
authors: Ergin
authors: E
authors: Kilic
authors: Depatment of Ophthalmology, Charité University Medicine Berlin, Berlin, Germany Institute for Pathology, Charité University Medicine Berlin, Berlin, Germany.
authors: Antonia M
authors: AM
authors: Joussen
authors: Depatment of Ophthalmology, Charité University Medicine Berlin, Berlin, Germany Institute for Pathology, Charité University Medicine Berlin, Berlin, Germany.
authors: Andreas
authors: A
authors: Lipski
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001706:Biopsy / Q000295:instrumentation; D005260:Female; D006801:Humans; D015811:Iris Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000532:radiotherapy; D008297:Male; D008545:Melanoma / Q000378:metabolism / Q000473:pathology* / Q000532:radiotherapy; D008866:Microsurgery; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000378:metabolism / Q000473:pathology* / Q000532:radiotherapy; D013508:Ophthalmologic Surgical Procedures / Q000295:instrumentation*; D061766:Proton Therapy; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor
keywords: Iris; Neoplasia; Pathology