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Vivian Schiedler, MD; Sander R. Dubovy, MD; Timothy G. Murray, MD

Arch Ophthalmol. 2007;125(5):680-683.

Retrospective analysis of surgical outcomes for enucleation in pediatric retinoblastoma stage 5B using the snare wire loop (n = 55) and standard curved enucleation scissors (n = 22) revealed that a statistically significant longer mean optic nerve length was obtained with the snare (13.35 mm) compared with scissors (11.05 mm; P = .005). Four scissor cases had prolonged bleeding and required thrombin (18.2%), but no snare cases had difficulty with hemostasis (P = .005). More crush artifact was seen with the snare than with scissors (P<.001), but this did not affect the ability to determine tumor involvement at the surgical margin. The enucleation snare should be considered a valuable surgical instrument in the small pediatric orbit since obtaining the longest optic nerve segment has prognostic implications in retinoblastoma.

Author Affiliations: Department of Ophthalmology, University of Washington, Seattle (Dr Schiedler); and Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Miami, Fla (Drs Dubovy and Murray).