To the Editor.
—Exenteration is most commonly used in the treatment of malignancies arising from the eye, ocular adnexa, and paranasal sinuses that are not amenable to radiation, chemotherapy, or en bloc excision. Intraoperative considerations include optimal removal of orbital soft tissues, control of bleeding, and maintenance of an intact bony orbit to prevent postoperative sino-orbital fistula formation. During exenteration, a curved scissors is the instrument most commonly recommended for transection and removal of the orbital contents.1,2 The remaining stump of orbital tissue tends to bleed briskly, and some authors recommend cross clamping the tissues at the orbital apex prior to transection to improve hemostasis.2 We recently used an enucleation snare (Storz) for the removal of the orbital soft tissues in seven patients undergoing exenteration for primary malignancies of the eye, eyelid, or lacrimal gland. Advantages of the enucleation snare include decreased bleeding from the tissue stump,
Buus DR, Tse DT. The Use of the Enucleation Snare for Orbital Exenteration. Arch Ophthalmol. 1990;108(5):636-637. doi:10.1001/archopht.1990.01070070022008