title: Snare technique for enucleation of eyes with advanced retinoblastoma.
abstract: 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.
authors.affiliation: Department of Ophthalmology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA. vivs@u.washington.edu
authors.forename: Vivian
authors.initials: V
authors.lastname: Schiedler
authors.forename: Sander R
authors.initials: SR
authors.lastname: Dubovy
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Murray
mesh_terms: D002648:Child; D002675:Child, Preschool; D015353:Eye Enucleation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009367:Neoplasm Staging; D009900:Optic Nerve / Q000473:pathology; D019572:Retinal Neoplasms / Q000473:pathology / Q000601:surgery*; D012175:Retinoblastoma / Q000473:pathology / Q000601:surgery*