Porous hydroxyapatite spheres are an ideal prosthetic device for orbital implantation because they are incorporated into soft tissues. Once vascularized, an eye prosthesis can be coupled to the sphere by a peg placed within a central motility hole. This hole should not be drilled while the sphere is avascular because of the risk of infection. Radionuclide scanning with Tc-99m methylene diphosphonate has been used to assess implant vascular ingrowth because radiophosphonate deposition within the sphere parallels vascularization. Using this technique, the authors examined the hydroxyapatite implants of 15 patients 6 months following insertion. Results showed that complete vascularization is best defined by planar imaging rather than SPECT. While the relative intensity of implant activity may be an important feature, uniformity of activity is probably more significant.