- Email: [email protected]
Vitrectomy Retinotomy Aspiration Biopsy of Choroidal Tumors
121
Correspondence
Vol. I l l , No. 1
of c h i l d r e n u n d e r g o i n g o c c l u s i o n t r e a t m e n t for a m b l y o p i a b y q u a n t i t a t i n g a c h a n g e in fixation preference. RONALD V. KEECH, M.D. PAMELA J. KUTSCHKE, B.S. Iowa City, Iowa
References 1. Zipf, R. P.: Binocular fixation pattern. Arch. Ophthalmol. 9 4 : 4 0 1 , 1976. 2. Campos, E. C , and Gulli, R.: Lack of alternation in patients treated for strabismic amblyopia. Am. J. Ophthalmol. 99:63, 1 9 8 5 . 3. Wright, K. W., Edelman, P. M., Walonker, F., and Yiu, S.: Reliability of fixation preference testing in diagnosing amblyopia. Arch. Ophthalmol. 104:549, 1986.
Vitrectomy Retinotomy Aspiration Biopsy of Choroidal Tumors EDITOR: In the a r t i c l e " V i t r e c t o m y r e t i n o t o m y aspira tion b i o p s y o f c h o r o i d a l t u m o r s , " by D . M. Fastenberg, P. T. F i n g e r , Q. C h e s s , J . H. Koizumi, and S. P a c k e r ( A m . J . O p h t h a l m o l . 1 1 0 : 3 6 1 , O c t o b e r 1 9 9 0 ) , the a u t h o r s d e s c r i b e a new b i o p s y t e c h n i q u e for c h o r o i d a l t u m o r s in volving v i t r e c t o m y , r e t i n o t o m y , a n d t u m o r b i opsy. A p p a r e n t l y the u s e o f v i t r e c t o m y i n s t r u m e n tation s h o u l d differentiate their t e c h n i q u e from others. W i t h b r i e f literature s e a r c h they w o u l d have found that v i t r e c t o m y h a s b e e n an i n d i s p e n s a b l e part o f the m e t h o d o f i n t e r n a l r e s e c tion I have d e s c r i b e d in a n i m a l s and h u m a n s . ' ^ I wonder, h o w e v e r , if it is p r u d e n t to g o to the t r o u b l e o f p e r f o r m i n g a v i t r e c t o m y a n d reti n o t o m y and leave the r e m a i n i n g t u m o r i n s i d e the eye w h e n it is p o s s i b l e to r e m o v e it c o m pletely. GHOLAM A. PEYMAN, M.D. New Orleans, Louisiana
References 1. Peyman, G. Α., and Barrada, Α.: Retinochoroidectomy ab interno. Ophthalmic Surg. 15:749, 1984. 2. Peyman, G. Α., and Cohen, S. B.: Ab interno resection of uveal melanoma. Int. Ophthalmol. 9:29, 1986. 3. Peyman, G. Α., and Gremillion, C. M., Jr.: Eye wall resection in the management of uveal neo plasms. Jpn. J. Ophthalmol. 33:458, 1 9 8 9 .
Reply EDITOR: We a c k n o w l e d g e d D r . P e y m a n ' s w o r k on the u s e o f v i t r e c t o m y i n s t r u m e n t a t i o n in the m a n a g e m e n t o f uveal m e l a n o m a s . ' T h e p u r p o s e o f our a r t i c l e was to offer an a l t e r n a t i v e b i o p s y t e c h n i q u e to that of a fine n e e d l e a s p i r a t i o n biopsy.^ We b e l i e v e that v i t r e c t o m y r e t i n o t o m y a s p i r a t i o n b i o p s y may h a v e a d v a n t a g e s over that t e c h n i q u e in t e r m s o f offering m o r e c o n trol, m i n i m i z i n g c o m p l i c a t i o n s , a n d p o s s i b l y delivering m o r e t u m o r for c y t o p a t h o l o g i c test ing. In r e s p o n s e to the q u e s t i o n as to w h e t h e r it is p r u d e n t to leave r e m a i n i n g t u m o r tissue in the eye after b i o p s y , w e must n o t e that in t h o s e eyes found to have c h o r o i d a l m e l a n o m a s , t r e a t m e n t e i t h e r b y p l a q u e t h e r a p y or e n u c l e a t i o n was r e c o m m e n d e d . We e m p h a s i z e that our p r o c e d u r e is offered o n l y as a b i o p s y technique. DAVID M. FASTENBERG, M.D. PAUL T. FINGER, M.D. QUINTUS CHESS, M.D. SAMUEL PACKER, M.D. Manhasset, New York JUNE H. KOIZUMI, M.D. New York, New York
References 1. Peyman, G. Α., and Cohen, S. B.: Ab interno resection of uveal melanoma. Int. Ophthalmol. 9:29, 1986. 2. Augsburger, J. J., and Shields, J. Α.: Fine needle aspiration biopsy of solid intraocular tumors. Indica tions, instrumentation, and techniques. Ophthalmic Surg. 15:34, 1984.
Correspondence
Vol. I l l , No. 1
of c h i l d r e n u n d e r g o i n g o c c l u s i o n t r e a t m e n t for a m b l y o p i a b y q u a n t i t a t i n g a c h a n g e in fixation preference. RONALD V. KEECH, M.D. PAMELA J. KUTSCHKE, B.S. Iowa City, Iowa
References 1. Zipf, R. P.: Binocular fixation pattern. Arch. Ophthalmol. 9 4 : 4 0 1 , 1976. 2. Campos, E. C , and Gulli, R.: Lack of alternation in patients treated for strabismic amblyopia. Am. J. Ophthalmol. 99:63, 1 9 8 5 . 3. Wright, K. W., Edelman, P. M., Walonker, F., and Yiu, S.: Reliability of fixation preference testing in diagnosing amblyopia. Arch. Ophthalmol. 104:549, 1986.
Vitrectomy Retinotomy Aspiration Biopsy of Choroidal Tumors EDITOR: In the a r t i c l e " V i t r e c t o m y r e t i n o t o m y aspira tion b i o p s y o f c h o r o i d a l t u m o r s , " by D . M. Fastenberg, P. T. F i n g e r , Q. C h e s s , J . H. Koizumi, and S. P a c k e r ( A m . J . O p h t h a l m o l . 1 1 0 : 3 6 1 , O c t o b e r 1 9 9 0 ) , the a u t h o r s d e s c r i b e a new b i o p s y t e c h n i q u e for c h o r o i d a l t u m o r s in volving v i t r e c t o m y , r e t i n o t o m y , a n d t u m o r b i opsy. A p p a r e n t l y the u s e o f v i t r e c t o m y i n s t r u m e n tation s h o u l d differentiate their t e c h n i q u e from others. W i t h b r i e f literature s e a r c h they w o u l d have found that v i t r e c t o m y h a s b e e n an i n d i s p e n s a b l e part o f the m e t h o d o f i n t e r n a l r e s e c tion I have d e s c r i b e d in a n i m a l s and h u m a n s . ' ^ I wonder, h o w e v e r , if it is p r u d e n t to g o to the t r o u b l e o f p e r f o r m i n g a v i t r e c t o m y a n d reti n o t o m y and leave the r e m a i n i n g t u m o r i n s i d e the eye w h e n it is p o s s i b l e to r e m o v e it c o m pletely. GHOLAM A. PEYMAN, M.D. New Orleans, Louisiana
References 1. Peyman, G. Α., and Barrada, Α.: Retinochoroidectomy ab interno. Ophthalmic Surg. 15:749, 1984. 2. Peyman, G. Α., and Cohen, S. B.: Ab interno resection of uveal melanoma. Int. Ophthalmol. 9:29, 1986. 3. Peyman, G. Α., and Gremillion, C. M., Jr.: Eye wall resection in the management of uveal neo plasms. Jpn. J. Ophthalmol. 33:458, 1 9 8 9 .
Reply EDITOR: We a c k n o w l e d g e d D r . P e y m a n ' s w o r k on the u s e o f v i t r e c t o m y i n s t r u m e n t a t i o n in the m a n a g e m e n t o f uveal m e l a n o m a s . ' T h e p u r p o s e o f our a r t i c l e was to offer an a l t e r n a t i v e b i o p s y t e c h n i q u e to that of a fine n e e d l e a s p i r a t i o n biopsy.^ We b e l i e v e that v i t r e c t o m y r e t i n o t o m y a s p i r a t i o n b i o p s y may h a v e a d v a n t a g e s over that t e c h n i q u e in t e r m s o f offering m o r e c o n trol, m i n i m i z i n g c o m p l i c a t i o n s , a n d p o s s i b l y delivering m o r e t u m o r for c y t o p a t h o l o g i c test ing. In r e s p o n s e to the q u e s t i o n as to w h e t h e r it is p r u d e n t to leave r e m a i n i n g t u m o r tissue in the eye after b i o p s y , w e must n o t e that in t h o s e eyes found to have c h o r o i d a l m e l a n o m a s , t r e a t m e n t e i t h e r b y p l a q u e t h e r a p y or e n u c l e a t i o n was r e c o m m e n d e d . We e m p h a s i z e that our p r o c e d u r e is offered o n l y as a b i o p s y technique. DAVID M. FASTENBERG, M.D. PAUL T. FINGER, M.D. QUINTUS CHESS, M.D. SAMUEL PACKER, M.D. Manhasset, New York JUNE H. KOIZUMI, M.D. New York, New York
References 1. Peyman, G. Α., and Cohen, S. B.: Ab interno resection of uveal melanoma. Int. Ophthalmol. 9:29, 1986. 2. Augsburger, J. J., and Shields, J. Α.: Fine needle aspiration biopsy of solid intraocular tumors. Indica tions, instrumentation, and techniques. Ophthalmic Surg. 15:34, 1984.