We performed a retrospective review of all germline retinoblastoma cases from January 1, 1985, until December 31, 2000, to identify all patients who had undergone unilateral enucleation with salvage of the other eye. Cases were drawn from the records of the University of Tennessee, Memphis, Department of Ophthalmology, Memphis; the records of the Ophthalmic Oncology Service at St Jude Children’s Research Hospital, Memphis; and the private records of Retina Associates of Florida, Tampa. Cases were enrolled only if the salvaged eye achieved a 12-month period of tumor quiescence and then subsequently underwent intraocular surgery for non–tumor-control reasons. Tumor quiescence was defined as lack of documented tumor growth, lack of vitreous or subretinal seeding, lack of anterior chamber seeding, and lack of metastases. Eligible intraocular surgery included cataract extraction, barrier laser for retinal break, scleral buckle procedure, pars plana vitrectomy, and Nd:YAG laser capsulotomy. Original treatment of the retinoblastoma was recorded, as was the Reese-Ellsworth classification. The 3 primary outcomes were tumor activity, visual acuity, and development of complications. Tumor activity was classified as quiescent, recurrent, and extraocular. Tumor recurrence included documented tumor growth or reactivation of the retinoblastoma in the eye (new vitreous seeding, new subretinal seeding, anterior chamber seeding). Extraocular tumor activity included extraocular extension, orbital involvement, and distant metastases. Visual acuity was assessed by Snellen acuity under best-corrected conditions. Nontumor complications were defined as retinal detachment (serous, rhegmatogenous, or tractional), cataract, vitreous hemorrhage, hypotony, elevated intraocular pressure, development of posterior capsular opacification, and epiretinal membrane formation. If the salvaged eye was enucleated, appropriate histopathologic analysis was performed.