Decreasing frequency of enucleation in patients with retinoblastoma.

We reviewed our 15-year experience with the management of 324 cases of retinoblastoma. There has been a definite trend away from enucleation in both unilateral and bilateral cases during recent years. In cases of unilateral retinoblastoma, the affected eye was salvaged in 4% of cases (two of 49) during the five-year interval from 1974 through 1978, in 14% of cases (seven of 50) from 1979 through 1983, and in 25% of cases (20 of 80) from 1984 through 1988. In cases of bilateral retinoblastoma, both affected eyes were salvaged in 4% of cases (one of 24) from 1974 through 1978, in 18% of cases (nine of 50) from 1979 through 1983, and in 25% of cases (18 of 71) from 1984 through 1988. Earlier diagnosis of retinoblastoma and refinements in conservative methods of management are believed to be the main reasons for this trend away from enucleation.