Summary of current used materials for orbital socket implants

Material typeAdvantagesDisadvantagesReferences
Ceramics
(hydroxyapatite)

  • Allows tissue ingrowth

  • Well tolerated

  • Provides good motility

  • Few complications

  • Can cause conjunctival abrasion

  • Not recommended for pediatric patients

  • High cost

[133, 137–142]
Autologous materials
(Bone, fat, skin, cartilage, muscle)

  • Cheaper alternative

  • Preferred in pediatric patients

  • Used to wrap exposed implants

  • Unpredictable graft uptake

  • Requires additional surgery

  • Risk of post-operative complications

[133–135, 143]
Silicone

  • Inertness

  • Biocompatible

  • Relatively good pliability

  • Used to produce spherical non-orbital implant

  • Low complication rate

  • Non-porous silicone preferred in children because it is easily removable

  • Easily surgically placed

  • Allows tissue ingrowth

  • Typical foreign body reaction with the formation of a dense avascular capsule around the implant

  • Fibrovascular ingrowth is not possible

  • Exposure often leads to implant removal, and is less treatable conservatively

[133, 143, 144]
Poly(methylmethacrylate) (PMMA)

  • Excellent biocompatibility

  • Widely used to fabricate intraocular lenses, orbital implants and rigid contact lenses

  • Low cost

  • Good clinical outcomes

  • Easily surgically placed

  • Fibrovascular ingrowth is not possible

  • Exposure often leads to implant removal, and is less treatable conservatively

[133, 143, 145–148]
Porous PE (polyethylene)
(Medpor)

  • Allows tissue ingrowth

  • Low-cost alternative to other implants

  • Soft surface and well tolerated by soft tissue

  • Reduced risk of complications

  • Pliable

  • Not recommended for pediatric patients

  • Slower vascularization compared to other materials

[133, 143, 146, 149]
Poly-HEMA (2-hydroxyethyl methacralate)
(Alphasphere)

  • Does not require tissue wrapping

  • Muscle can be sutured directly to the implant

  • Smooth surface

  • Limit risk of exposure

  • Allows tissue ingrowth

  • Implant disintegration

  • Fragmentation

  • Partial extrusion

  • Host reaction

[133, 143, 146, 150]