Abstract

ObjectiveTo perform micro-incision, trans-iridal, aspiration-cutter-assisted biopsy for ciliary body tumours. DesignRetrospective, nonrandomized, observational, interventional case series. MethodsFive consecutive patients undergoing ciliary body tumour biopsy were clinically diagnosed using slit-lamp photography, gonioscopy, high-frequency ultrasound imaging, and systemic radiographic staging. A 1–2 mm clear cornea incision was placed opposite to the central clock hour of the ciliary body tumour. Viscoelastic was infused into the anterior chamber for stabilization and endothelial protection. Then, a 27-gauge aspiration cutter was used to make an iridotomy at the iris root and then extend through the iris into the tumour. Biopsy was performed using mechanical cutting starting at 300 cuts per minute and aspiration at 600 mm Hg. After withdrawal of the cutter from the eye, the effluent tube was flushed into a 3 cc syringe, inspected for specimen under the operating microscope and sent for pathology. Multiple biopsies were performed on each patient. Viscoelastic was removed and Seidel examination of the corneal wound performed. ResultsFive eyes were biopsied. A mean 3.6 passes were used to obtain tumour tissue. Tumour cells and tissue were obtained in all cases. Cytologic, histopathologic, and immuno-histochemical analysis were performed (100%, n = 5/5). Diagnoses included melanoma (60%, n = 3/5), melanocytoma (20%, n = 1/5), and leiomyoma (20%, n = 1/5). Transient postoperative hyphemas cleared within 1 week (80%, n = 4/5). No secondary glaucoma, infection, or cataracts were noted. ConclusionAspiration-cutter biopsy through the iris root provided a minimally invasive, safe method for obtaining ciliary body tissue for cytology, histopathology, and immunohistochemical analysis.

Highlights

  • Biopsy remains an indispensable tool for diagnosis of select ciliary body tumours and remains the only way to allow cytologic, histopathologic, immunohistochemical, genetic, and molecular analysis.7À12 we present a new method of biopsy for ciliary body tumors

  • Cells and tissue were provided for pathology analysis and diagnoses were issued for each case (Fig. 2)

  • Case #2 reveals a normal-appearing anterior chamber angle anterior obscuring the subjacent ciliary body melanoma best seen on Ultrasound biomicroscopy (UBM) (Fig. 3A, B)

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Summary

Objective

To perform micro-incision, trans-iridal, aspiration-cutter-assisted biopsy for ciliary body tumours. Conclusion: Aspiration-cutter biopsy through the iris root provided a minimally invasive, safe method for obtaining ciliary body tissue for cytology, histopathology, and immunohistochemical analysis. Conclusion: La biopsie par aspiration-section à travers la racine de l'iris représente une méthode sûre et peu invasive pour obtenir des cellules du corps ciliaire en vue d'analyses cytologiques, histopathologiques et immunohistochimiques. FNAB of ciliary body tumors involves placing the needle through the peripheral iris or sclera to a position where its sharp tip cannot be observed while sampling the tumour or interacting with adjacent tissues. Iris, sclero-invasive, and orbital tumors have been biopsied using machine-modulated, aspiration-cutterenhanced methods under viscoelastic stabilization of the anterior chamber.8À11,19,20 Both cells and tissue samples. This study investigates the use of Finger’s aspiration-cutter technique for trans-iris biopsy of ciliary body tumors

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