Proptosis and Anterior Dislocation as a Late Noninflammatory Complication of Failure of Tissue Integration in the Alphasphere Implant.

A 57-year-old healthy female underwent enucleation for choroidal melanoma with primary implantation of a 2-hydroxyethyl methacrylate sphere (AlphaSphere, Addition Technology, Des Plaines, IL). Her course was uneventful, with successful prosthetic fitting 6 weeks postoperatively. She returned 2 years later, with anterior displacement of the implant, poor implant movement, and poor prosthetic fit. There was no defect in the conjunctiva, Tenon's layer or evidence of inflammation. Successful orbital implant exchange was performed, replacing the AlphaSphere with an eyebank-scleral wrapped acrylic implant. Intraoperative findings revealed dissolution of the scaffolding aspect of the anterior implant, with loss of extraocular muscle attachments and no fibrovascular ingrowth. This case demonstrates late AlphaSphere failure in an otherwise unremarkable course; further review of similar cases or a larger study is warranted to examine the efficacy of this relatively new implant.