BACKGROUND AND OBJECTIVE: Porous anophthalmic orbital implants are used widely. This study evaluates risk factors for porous anophthalmic orbital implant complications and compares complication rates of hydroxyapatite, porous polyethylene, and polyglactin mesh-wrapped aluminum oxide implants. PATIENTS AND METHODS: The records of 105 patients (110 eyes) who received porous anophthalmic orbital implants for any indication were reviewed retrospectively. Complications were recorded and correlated with potential risk factors, including implant material. All patient records were de-identified to protect privacy. RESULTS: Porous polyethylene and aluminum oxide implants were associated with higher exposure rates (porous polyethylene: odds ratio 6.1 [1.29, 29.1]; aluminum oxide: odds ratio 6.0 [1.58, 23.1]; P = .004) and higher overall complication rates compared to hydroxyapatite implants. CONCLUSION: Implant material may be a risk factor for several anophthalmic clinical outcomes.