title: Microincision, aspiration cutter-assisted multifocal iris biopsy for melanoma.
abstract: OBJECTIVE
  To describe a minimally invasive method to create multifocal full-thickness surgical iridectomy biopsies.
  
  
  METHODS
  Seven patients suspected to have diffuse iris melanoma underwent multifocal surgical iridectomy biopsy through a single 1.0-mm clear corneal incision. A 25-G inked trocar was used to create one visible corneal portal, through which the anterior chamber was filled with sodium hyaluronate 1%. Then, a 25-G aspiration cutter probe was introduced through the corneal incision such that the aspiration portal was occluded by the iris biopsy sites. Then aspiration (600 mm Hg) cutting (300 cuts per minute) was used to create full- and partial-thickness surgical iridectomy biopsies at multiple locations. After each biopsy the probe was removed, and its contents aspirated into a separate 3-mL syringe (marked by clock hour location). The sodium hyaluronate 1% was removed and wound checked for leakage.
  
  
  RESULTS
  Diagnostic specimens were obtained in all cases. Five were found to be diffuse iris melanomas and 2 were indeterminate iris melanocytic proliferations. No patients developed a secondary increase in intraocular pressure, hyphema, infection, cataract, or vision loss. No cases of intraocular tumor dissemination were observed. No patient complained of glare or monocular diplopia. Three of 7 corneal wounds were self-sealing.
  
  
  CONCLUSIONS
  Multifocal surgical iridectomy biopsy can be minimally invasive and effective allowing for partial- and full-thickness iris biopsy. Use of a 25-G aspiration cutting probe allowed for small incision surgery, rapid rehabilitation, and no significant complications.
authors.affiliation: The New York Eye Cancer Center, New York, NY - USA.|New York Eye and Ear Infirmary of Mt. Sinai, New York, NY - USA.|New York University School of Medicine, New York, NY - USA.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Finger
authors.affiliation: New York Eye and Ear Infirmary of Mt. Sinai, New York, NY - USA.
authors.forename: Tatyana
authors.initials: T
authors.lastname: Milman
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D032801:Iridectomy; D007498:Iris / Q000601:surgery*; D015811:Iris Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000601:surgery; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013396:Suction / Q000295:instrumentation* / Q000379:methods