25 Gauge Incision Anterior Segment Surgery Found Helpful For Both Tumor Biopsy: The Finger Iridectomy Technique

The day after the 1 mm incision "FIT" biopsy, a slit lamp photograph shows the partial thickness biopsy of the tumor.
The day after the 1 mm incision “FIT” biopsy, a slit lamp photograph shows the partial thickness biopsy of the tumor.

Iris, iridociliary, and other anterior segment tumors can be biopsied to help determine if they are a benign or malignant. In the past, a biopsy was either performed by aspiration through a needle [fine needle aspiration biopsy (FNAB)] or by a surgical iridectomy. The advantage of a needle biopsy was the very small “needle” incision that required no stitches or consequences for vision. Unfortunately, it was difficult to do more that scratch the tumor with the needle while aspirating a few cells. Using a sharp needle, the tumor often bleeds, clouding the view and making biopsy more difficult. In the past, the alternative was a surgical iridectomy that required a relatively large corneal incision, removal of a full-thickness piece of iris and sutures to close the corneal wound.

In an effort to make iris and ciliary body tumor biopsy safer and more effective, Dr. Finger invented a technique for minimally invasive iris biopsy (with less surgical trauma). This new technique combines the benefit of 1-mm typically sutureless incision with the ability to retrieve iris tumor biopsy specimens for pathology analysis. He has used this technique to perform tumor biopsy, iridotomy and to remove iris melanoma.

Dr. Finger has also used this technique to treat narrow angle glaucoma. Dr. Finger says, “it would be particularly useful for the treatment of children and mentally challenged adults who are not able to have the laser iridotomy method.” FIT can be used to surgically create a small hole in the iris through a 25 gauge self-sealing incision. “Micro-incision surgery should be safer for this group of patients who might rub their eye after surgery.”

For more information this technique has been recently published in the British Journal of Ophthalmology and Graefes Archive of Clinical and Experimental Ophthalmology.

The Finger iridectomy technique: small incision biopsy of anterior segment tumors.
Finger PT, Latkany P, Kurli M, Iacob C
The British Journal of Ophthalmology 2005;89:946-949

Small incision surgical iridotomy and iridectomy.
Finger PT.
Graefes Arch Clin Exp Ophthalmol. 2005 Aug 2;:1-2

The Finger Iridectomy Technique for Glaucoma
Finger PT
British Journal of Ophthalmology 2007;91:1089-1090.

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