Perspective on orbital enucleation implants

The philosophy and design of orbital enucleation implants have evolved significantly over the past 50 years. Animal studies and improved imaging techniques have changed our understanding about the physiology and anatomy of the post-enucleation orbit. Changes in implant design and biomaterials have reduced complication rates. It is our impression that for many ophthalmic professionals in training, the rational behind the current thinking in implant design and biomaterials is unclear. This is in part related to the older literature on orbital enucleation implants, which is scattered and at times contradictory. This review aims to present the historical information in a coherent and concise form; provide evidence based review of changes in the practice patterns of enucleation; identify areas of continuing controversy; and highlight gaps in the scientific literature about orbital implants, in particular, the poor understanding of implant and prosthesis motility.