All cases of children undergoing enucleation for advanced retinoblastoma by the same surgeon (T.G.M.) at Bascom Palmer Eye Institute between March 1994 and March 2005 were retrospectively reviewed. Data was collected from the medical record, operative report, pathology requisition form, and pathology report. The following were recorded: the patient's age at enucleation, sex, stage of retinoblastoma, type of enucleation instrument used (snare or scissors), length of optic nerve obtained prior to fixation in formalin as measured in the operating room, and intraoperative adverse events. Only fresh optic nerve length measurements were used since formalin fixation has been shown to produce approximately 30% shrinkage.4 In addition, 20 histopathologic specimens (10 snare cases and 10 scissor cases) were randomly selected and reviewed in blinded fashion with the ocular pathologist for analysis of crush artifact at the surgical margin. Study approval was obtained from the University of Miami's institutional review board.