title: Vitreoretinal surgery for complications of choroidal tumor biopsy.
abstract: OBJECTIVE
  To determine the outcomes of vitreoretinal surgery after choroidal tumor biopsy.
  
  
  METHODS
  Retrospective, single-center, consecutive case series.
  
  
  METHODS
  A total of 739 consecutive patients undergoing choroidal tumor biopsy.
  
  
  METHODS
  All subjects who underwent transretinal or transscleral choroidal tumor biopsy for diagnostic or prognostic purposes between May 1993 and May 2013 were identified in our database. We then reviewed patients who subsequently required secondary vitreoretinal surgery for complications arising from such biopsies.
  
  
  METHODS
  Reason for vitreoretinal surgery, association with biopsy procedure, best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution [logMAR]), intraocular or extrascleral tumor dissemination, resolution of vitreous hemorrhage, reattachment of the retina with a single vitreoretinal procedure, number of additional vitrectomies undertaken, and number of enucleations.
  
  
  RESULTS
  A total of 20 of 739 eyes (2.7%) underwent vitreoretinal surgery for complications arising from choroidal tumor biopsy. The tumors consisted of choroidal melanoma in all 20 eyes. The reasons for the secondary surgery included persistent vitreous hemorrhage in 1.9% (14/739), rhegmatogenous retinal detachment in 0.7% (5/739), and endophthalmitis in 0.14% (1/739). Median BCVA improved from 2.0 logMAR (mean, 1.92 logMAR; range, 0.8-2.7 logMAR) before vitrectomy to 0.72 logMAR (mean, 0.88 logMAR; range, -0.14 to 2.7 logMAR) after vitrectomy and 0.76 logMAR (mean, 1.14 logMAR; range, 0.1-3.0 logMAR) at the final visit (P < 0.0001, t test). Permanent resolution of vitreous hemorrhage was achieved in 6 of 14 patients, and reattachment of the retina was achieved in 2 of 5 patients after the first vitrectomy. A median of 1 (mean, 1.5; range, 1-3) additional vitrectomy was performed. Enucleation was necessary in 3 of 20 eyes (15%). There were no cases of intraocular invasion or extrascleral extension after vitrectomy.
  
  
  CONCLUSIONS
  Vitrectomy for complications of choroidal tumor biopsy is rare. Such corrective surgery is complex and is best undertaken by specialized ocular oncologists or vitreoretinal surgeons with experience in managing this problem.
authors.affiliation: Ocular Oncology Centre, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom. Electronic address: grixti.andre@gmail.com.
authors.forename: Andre
authors.initials: A
authors.lastname: Grixti
authors.affiliation: Ocular Oncology Centre, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Martina
authors.initials: M
authors.lastname: Angi
authors.affiliation: Ocular Oncology Centre, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom; Ocular Oncology Service, Departments of Ophthalmology and Radiation Oncology, University of California, San Francisco, San Francisco, California.
authors.forename: Bertil E
authors.initials: BE
authors.lastname: Damato
authors.affiliation: Ocular Oncology Centre, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Fidan
authors.initials: F
authors.lastname: Jmor
authors.affiliation: Ocular Oncology Centre, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Lazaros
authors.initials: L
authors.lastname: Konstantinidis
authors.affiliation: Ocular Oncology Centre, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Carl
authors.initials: C
authors.lastname: Groenewald
authors.affiliation: Ocular Oncology Centre, St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Heimann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D002830:Choroid Neoplasms / Q000175:diagnosis; D009877:Endophthalmitis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis; D008875:Middle Aged; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D014792:Visual Acuity; D057586:Vitreoretinal Surgery / Q000379:methods; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000601:surgery*