Orbital implants and prostheses: postoperative computed tomographic appearance

Computed tomographic (CT) scans of 19 patients with 10 right and nine left orbital implants were reviewed. Except for orbital soft-tissue swelling due to recent surgery or infection, CT scans obtained with both the implant and prosthesis in place showed relative symmetry of the postoperative side and the native globe. Benign air collections were often associated with either the implant or prosthesis interface or with seating of the prosthesis in the conjunctival fornices. Six patients had either cartilage, silicone, or glass beads placed surgically along the orbital floor to elevate the implants, four having had prior depressed orbital floor fractures. CT identified implant migration in five patients. The orbital prosthesis, usually constructed of solid methylmethacrylate, is fitted over the implant and simulates the appearance of the eye of the contralateral side. The operative anatomy and its relation to the CT appearance of the implant and external prosthesis are reviewed.