Orbital Implants: Classification and Outcomes

  • Sarah W. DeParis
  • Nicholas MahoneyEmail author


Orbital implants are placed during or after eye removal surgeries. Implants support the orbital tissues, add volume to the eye socket, and support movement of an ocular prosthetic. Modern implants are made of either porous or nonporous materials. There are a variety of pros and cons to each material type with the ultimate ideal implant being well-tolerated and affordable as well as resistant to infection, exposure, migration, and extrusion. Porous materials allow fibrovascular ingrowth and as such can tolerate placement of a motility peg. The potential benefits of each implant material are reviewed as well as common problems and management solutions after implant placement.


Orbital implants Eye removal Enucleation Evisceration Eye socket surgery Anophthalmia Anophthalmic socket Ocular implant 


  1. 1.
    Chalasani R, Poole-Warren L, Conway RM, Ben-Nissan B. Porous orbital implants in enucleation: a systematic review. Surv Ophthalmol. 2007;52(2):145–55.PubMedGoogle Scholar
  2. 2.
    Baino F, Perero S, Ferraris S, et al. Biomaterials for orbital implants and ocular prostheses: overview and future prospects. Acta Biomater. 2014;10(3):1064–87.PubMedGoogle Scholar
  3. 3.
    Su GW, Yen MT. Current trends in managing the anophthalmic socket after primary nucleation and evisceration. Ophthal Plast Reconstr Surg. 2004;20(4):274–80.PubMedGoogle Scholar
  4. 4.
    Mahoney NR, Grant MP, Iliff NT, Merbs SL. Exposure rate of smooth surface tunnel porous polyethylene implants after enucleation. Ophthal Plast Reconstr Surg. 2014;30(6):492–8.PubMedGoogle Scholar
  5. 5.
    Wladis EJ, Aakalu VK, Sobel RK, Yen MT, Bilyk JR, Mawn LA. Orbital implants in enucleation surgery: a report by the American Academy of ophthalmology. Ophthalmology. 2018;125(2):311–7.PubMedGoogle Scholar
  6. 6.
    Schellini S, Jorge E, Sousa R, Burroughs J, El-Dib R. Porous and nonporous orbital implants for treating the anophthalmic socket: a meta-analysis of case series studies. Orbit. 2016;35(2):78–86.PubMedGoogle Scholar
  7. 7.
    Custer PL, Trinkaus KM, Fornoff J. Comparative motility of hydroxyapatite and alloplastic enucleation implants. Ophthalmology. 1999;106(3):513–6.PubMedGoogle Scholar
  8. 8.
    Colen TP, Paridaens DA, Lemij HG, Mourits MP, van Den Bosch WA. Comparison of artificial eye amplitudes with acrylic and hydroxyapatite spherical enucleation implants. Ophthalmology. 2000;107(10):1889–94.PubMedGoogle Scholar
  9. 9.
    Custer PL, Trinkaus KM. Porous implant exposure: incidence, management, and morbidity. Ophthal Plast Reconstr Surg. 2007;23(1):1–7.PubMedGoogle Scholar
  10. 10.
    Guillinta P, Vasani SN, Granet DB, Kikkawa DO. Prosthetic motility in pegged versus unpegged integrated porous orbital implants. Ophthal Plast Reconstr Surg. 2003;19(2):119–22.PubMedGoogle Scholar
  11. 11.
    Shields CL, Uysal Y, Marr BP, et al. Experience with the polymer-coated hydroxyapatite implant after enucleation in 126 patients. Ophthalmology. 2007;114(2):367–73.PubMedGoogle Scholar
  12. 12.
    Blaydon SM, Shepler TR, Neuhaus RW, White WL, Shore JW. The porous polyethylene (Medpor) spherical orbital implant: a retrospective study of 136 cases. Ophthal Plast Reconstr Surg. 2003;19(5):364–71.PubMedGoogle Scholar
  13. 13.
    Karesh JW, Dresner SC. High-density porous polyethylene (Medpor) as a successful anophthalmic socket implant. Ophthalmology. 1994;101(10):1688–95; discussion 1695–1686.PubMedGoogle Scholar
  14. 14.
    Rubin PA, Popham JK, Bilyk JR, Shore JW. Comparison of fibrovascular ingrowth into hydroxyapatite and porous polyethylene orbital implants. Ophthal Plast Reconstr Surg. 1994;10(2):96–103.PubMedGoogle Scholar
  15. 15.
    Jordan DR, Brownstein S, Dorey M, Yuen VH, Gilberg S. Fibrovascularization of porous polyethylene (Medpor) orbital implant in a rabbit model. Ophthal Plast Reconstr Surg. 2004;20(2):136–43.PubMedGoogle Scholar
  16. 16.
    Goldberg RA, Dresner SC, Braslow RA, Kossovsky N, Legmann A. Animal model of porous polyethylene orbital implants. Ophthal Plast Reconstr Surg. 1994;10(2):104–9.PubMedGoogle Scholar
  17. 17.
    Jordan DR, Klapper SR, Gilberg SM, Dutton JJ, Wong A, Mawn L. The bioceramic implant: evaluation of implant exposures in 419 implants. Ophthal Plast Reconstr Surg. 2010;26(2):80–2.PubMedGoogle Scholar
  18. 18.
    Ma X, Schou KR, Maloney-Schou M, Harwin FM, Ng JD. The porous polyethylene/bioglass spherical orbital implant: a retrospective study of 170 cases. Ophthal Plast Reconstr Surg. 2011;27(1):21–7.PubMedGoogle Scholar
  19. 19.
    Choi HY, Lee JE, Park HJ, Oum BS. Effect of synthetic bone glass particulate on the fibrovascularization of porous polyethylene orbital implants. Ophthal Plast Reconstr Surg. 2006;22(2):121–5.PubMedGoogle Scholar
  20. 20.
    Nunery WR, Cepela MA, Heinz GW, Zale D, Martin RT. Extrusion rate of silicone spherical anophthalmic socket implants. Ophthal Plast Reconstr Surg. 1993;9(2):90–5.PubMedGoogle Scholar
  21. 21.
    Anderson RL, Yen MT, Lucci LM, Caruso RT. The quasi-integrated porous polyethylene orbital implant. Ophthal Plast Reconstr Surg. 2002;18(1):50–5.PubMedGoogle Scholar
  22. 22.
    Thaller VT. Enucleation volume measurement. Ophthal Plast Reconstr Surg. 1997;13(1):18–20.PubMedGoogle Scholar
  23. 23.
    Tyers AG, Collin JR. Orbital implants and post enucleation socket syndrome. Trans Ophthalmol Soc U K. 1982;102(Pt 1):90–2.PubMedGoogle Scholar
  24. 24.
    Smit TJ, Koornneef L, Zonneveld FW, Groet E, Otto AJ. Computed tomography in the assessment of the postenucleation socket syndrome. Ophthalmology. 1990;97(10):1347–51.PubMedGoogle Scholar
  25. 25.
    Custer PL, Kennedy RH, Woog JJ, Kaltreider SA, Meyer DR. Orbital implants in enucleation surgery: a report by the American Academy of ophthalmology. Ophthalmology. 2003;110(10):2054–61.PubMedGoogle Scholar
  26. 26.
    Tawfik HA, Dutton JJ. Primary peg placement in evisceration with the spherical porous polyethylene orbital implant. Ophthalmology. 2004;111(7):1401–6.PubMedGoogle Scholar
  27. 27.
    Edelstein C, Shields CL, De Potter P, Shields JA. Complications of motility peg placement for the hydroxyapatite orbital implant. Ophthalmology. 1997;104(10):1616–21.PubMedGoogle Scholar
  28. 28.
    Yoon JS, Lew H, Kim SJ, Lee SY. Exposure rate of hydroxyapatite orbital implants a 15-year experience of 802 cases. Ophthalmology. 2008;115(3):566–572 e562.PubMedGoogle Scholar
  29. 29.
    Smit TJ, Koornneef L, Groet E, Zonneveld FW, Otto AJ. Prosthesis motility with and without intraorbital implants in the anophthalmic socket. Br J Ophthalmol. 1991;75(11):667–70.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Kawai S, Suzuki T, Kawai K. Mobility of hydroxyapatite orbital implant covered with autologous sclera. Jpn J Ophthalmol. 2000;44(1):68–74.PubMedGoogle Scholar
  31. 31.
    Heher KL, Katowitz JA, Low JE. Unilateral dermis-fat graft implantation in the pediatric orbit. Ophthal Plast Reconstr Surg. 1998;14(2):81–8.PubMedGoogle Scholar
  32. 32.
    Dresner SC, Karesh JW. Primary implant placement with evisceration in patients with endophthalmitis. Ophthalmology. 2000;107(9):1661–4; discussion 1664–1665.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Oculoplastic SurgeryWilmer Eye Institute/Johns Hopkins HospitalBaltimoreUSA
  2. 2.Department of OphthalmologyJohns Hopkins HospitalBaltimoreUSA

Personalised recommendations