Long-Term Observation of Orbital Development in Patients With Retinoblastoma Following Unilateral Enucleation

Background

This study aims to investigate bilateral orbital development differences and influencing factors in retinoblastoma patients undergoing unilateral enucleation.

Methods

A retrospective comparative analysis was performed on patients from Beijing Tongren Hospital (January 2011–December 2020). Preoperative and 3 months, 1 year, 3 years postoperative, and the final follow-up imaging data were collected, with bilateral orbital volumes reconstructed using ITK-SNAP software.

Results

Thirty-nine patients were followed for an average of 7.7 ± 2.45 years. Average orbital volumes (mm³) for the surgical and nonsurgical sides before surgery were 14,323.81 ± 4596.60 and 14,457.93 ± 4732.26 (p = 0.330). Postoperative volumes at 3 months were 16,481.84 ± 4034.21 and 16,866.45 ± 3999.71 (p = 0.007). At 12 months, volumes were 16,798.16 ± 3323.33 and 18,119.16 ± 3840.27 (p = 0.000). At 36 months, volumes were 18,758.26 ± 2917.35 and 19,973.55 ± 3189.83 (p = 0.000). The last follow-up volumes were 20,523.78 ± 3221.20 and 21,576.78 ± 3381.96 (p = 0.000). Bilateral volume differences were 2.28%, 7.29%, 6.08%, and 4.88% at 3 months, 12 months, 36 months after operation, and final follow-up. The growth trajectory on the surgical side demonstrated growth restrictions, accompanied by a shift in the growth peak. Factors affecting development included the age at the time of operation and the type of orbital implants.

Conclusions

Volumetric analysis revealed active orbital development between 3 and 12 months post-enucleation, followed by a significant plateau phase. The final orbital volume deficit in the surgical orbit stabilized at approximately 5% compared to the non-operated orbit. Hydrogel implants demonstrated a trade-off: potentially reduced volume deficit but higher complication risks.