Long-term surgical outcomes of primary silicone orbital implant after orbital evisceration in infectious versus non-infectious cases

Introduction Even with recent improvements, the optimal timing of orbital implant placement after evisceration surgery – particularly in infected cases – remains unclear. This study aimed to compare the long-term outcomes of primary silicone orbital implants after evisceration for infectious and non-infectious causes, focusing mainly on implant-related complications such as exposure or extrusion. Methods A total of 32 eyes that underwent evisceration were analyzed. Patients were divided into two groups: infectious causes (Group A, n = 10) and non-infectious causes (Group B, n = 22). Postoperative follow-up duration, implant size, histopathological results, and complications – including implant exposure or extrusion – were evaluated. Results Demographic characteristics were similar between the groups. The mean follow-up duration was 34.0 ± 17.7 months in group A and 28.18 ± 18.1 months in group B ( p = 0.403). The mean implant size was 17.8 ± 2.6 mm in group A and 18.3 ± 1.8 mm in group B ( p = 0.693). Mild symblepharon occurred in 2 patients (20%) in group A, while upper lid ptosis was noted in 2 patients (9%) in group B. No cases of implant exposure, extrusion, or sympathetic ophthalmia were observed in either group. Conclusion Orbital evisceration results in comparable long-term outcomes for both infectious and non-infectious indications, with no observed cases of implant exposure or extrusion. These findings support the safe use of primary silicone implants in both scenarios when appropriate surgical technique is applied and adequate postoperative follow-up is provided.