The aim of this study was to evaluate the surgical outcomes of polyetheretherketone (PEEK) implants in the reconstruction of orbital bony defects.

The study includes 10 patients with complex craniofacial needs who underwent reconstruction for bony orbital defects using PEEK implants at the Craniofacial unit in Chelsea and Westminster Hospital, from 2011 to 2017. All patients underwent ophthalmological, as well as radiological evaluation. Demographic data as well as the short and longterm complications were recorded.

The age range of the ten patients who underwent orbital reconstruction using the custom-made PEEK implants was 16 to 72 years (average 42.8 years). The range of follow-up was 4 to 35 months (average 14.9 months). All patients received post operative antibiotic prophylaxis, however 3 patients (30%) developed infection resulting in removal of their implants. For two patients this was in the immediate postoperative period, two weeks following surgery. The third patient with granulomatosis with polyangiitis developed implant exposure visible through the lower fornix, with an associated polymicrobial infection. This necessitated prolonged antibiotic and antifungal treatment, and delayed removal of the implant 10 months following surgery. Six patients, including the 3 who had implant removal, required further surgery as part of their rehabilitation; including removal of retention cyst, lower lid tightening surgery, debulking of forehead flap, lacrimal stent insertion, and excision of neurofibroma.

Orbital reconstruction in craniofacial patients remains a challenge, and customised PEEK implants are designed with increased precision to replace exact anatomy. Our series shows a 30% implant removal due to infection.