Published chapter on 15-gauge biopsy of uveal tumours

Bertil Damato and Carl Groenewald have just published a chapter in a textbook on vitreo-retinal surgery, in which they describe their techniques for sampling intraocular tumours, such as melanoma. These methods use a 25-gauge vitreous cutter ('mini-vacuum cleaner'), which enables a relatively large tumour sample to be obtained quickly and safely, under local anaesthesia.

This biopsy technique has greatly enhanced our ability to distinguish melanomas originating in the eye from metastases spreading to the eye from distant parts of the body.

Larger samples of intraocular melanoma also allow us to perform cytogenetic studies to determine whether or not the tumour is life-threatening. This information is very reassuring to patients with a 'good melanoma' and therefore with a normal life-expectancy. Furthermore, patients with a 'bad melanoma' can be offered more intensive care, optimising any chances of prolonging life.

We are currently undertaking quality-of-life studies to check whether the psychological benefits justify any risks to the eye. Our initial impressions suggest that we may soon be offering biopsy of intraocular melanoma to all patients, including those treated by radiotherapy.

(Vitreo-retinal surgery. Eds Kirchhof B and Wong D. Essentials in Ophthalmology. GK Krieglstein and Weinreb RN. Springer. Berlin. 2007).