Fine-needle aspiration biopsy of the iris

Fine-needle aspiration biopsy (FNAB) specimens obtained from nine consecutive iris lesions were examined. The lesions included primary malignant melanoma (four cases), metastatic melanoma, metastatic adenocarcinoma, leukemic infiltrate, lymphocytic infiltrate, and epithelial ingrowth. Subsequent histopathologic correlation was performed in all cases. Patient treatment influenced by the results of the FNABs included enucleation (three cases), clinical observation (two cases), external beam irradiation (two cases), resection, and radioactive plaque application. No complications occurred from the FNABs. Fine-needle aspiration biopsy of the iris can be performed with local anesthesia at the slit lamp as an outpatient procedure. In general, FNAB is a safe, effective method of obtaining diagnostic material from primary neoplastic, secondary neoplastic, and degenerative processes involving the iris. Limitations of the procedure include discrepancies in interpretation of the cytologic study and inadequate specimen.