The authors report on a retrospective, multicentre, comparative case series looking at prophylactic antibiotics and the incidence of orbital cellulitis following enucleation or evisceration. Of the 644 cases included in the analysis, all received a single perioperative intravenous dose of antibiotics but only 59% received prophylactic postoperative antibiotics. Ninety percent of these patients received an orbital implant. Only two cases developed signs suggestive of postoperative infection, with one patient being from the postoperative antibiotic group, whilst the other patient did not receive postoperative prophylaxis. Neither of the two cases had a positive culture and both were treated without hospitalisation. Even patients with infective indications for surgery did not reveal an increased incidence of postoperative infection in those who did not receive postoperative prophylaxis. The authors conclude that their study supports the clinical safety of withholding prophylactic pre-operative antibiotics in patients undergoing sterile orbital surgery with or without alloplastic orbital implant insertion.