Conjunctival map biopsies
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This is Richard Allen at the University of Iowa.
This video demonstrates map biopsies in a patient with biopsy proven sebaceous cell carcinoma.
The diagram demonstrates where a total of 14 biopsies will be taken from the left side. A 4-0 Silk suture is placed through the lower lid margin to aid in exposure. The first biopsy will be taken from the nasal palpebral conjunctiva of the lower lid. This is performed with Westcott scissors. The next biopsy is taken from the central lower palpebral conjunctiva, followed by the lateral lower palpebral conjunctiva. Attention is then directed to the bulbar conjunctiva inferiorly where a medial, central, and lateral biopsy are taken.
A 4-0 Silk suture is then placed through the upper lid margin and the upper eyelid is everted. Similar biopsies are taken from the superior nasal, central, and lateral palpebral conjunctiva. The bulbar conjunctiva is then biopsied at the medial, central, and lateral locations. Two final biopsies will then be taken from the medial bulbar and lateral bulbar conjunctiva. Again, the purpose of these biopsies is to determine the extent of disease in a patient with sebaceous cell carcinoma.