A retrospective study was performed on 114 patients who had received an intraorbital ball implant after removal of an eye: 44 had a primary implant inserted at the time of enucleation and 70 a secondary implant, inserted at a later date. We observed distinct advantages in the primary implantation group. Patients with a primary implant, an acrylic ball covered with sclera inserted within Tenon's capsule, had better cosmetic results and a lower complication rate and fewer needed any other therapeutic measures. Of the patients with primary implants 89% did not require further treatment, as against 51% with secondary implants.