It is an operation that restores vision in the most severe cases of corneal scarring causing secondary blindness. Modified osteoodontokeratoprosthesis technique step 2. Osteoodontokeratoprosthesis definition of osteoodonto. A, removal of the cheek mucosal graft covering the cornea and the flieringa ring. The osteoodontokeratoprosthesis ookp stevens johnson. Presently, there are three keratoprosthesis with a widespread use in humans. This is a noncomparative retrospective case series of 14 patients who underwent ookp surgery between 2001 and 2016 at the sussex eye hospital, brighton, uk, because of severe chemical and thermal injuries. Apr 30, 2016 osteo odonto keratoprosthesis ookp is a surgical procedure for replacing severe damaged corneas when corneal transplant is impossible and giving sight back. Osteoodontokeratoprosthesis ookp also known as tooth in eye surgery is a medical procedure to restore vision in the most severe cases of corneal and ocular surface patients. Around 5 million of these cases are due to corneal pathology. The keratoprosthesis is soaked in 10 ml of the patients blood, then buried in the infraorbital area contralateral to the eye being restored.
Pdf the osteoodontokeratoprosthesis ookp researchgate. This involves removing a canine tooth from the patient, shaping and drilling to allow implantation of an artificial plastic corneal device and finally. We studied perioperative concerns of patients who underwent the staged ookp procedure. Other models were used over the years, but since 1963 strampellis osteoodontokeratoprosthesis is the technique of choice, a procedure which, after certain modifications, continues to be used at present by professor barraquers associate, dr. Similarly, a lamina can also be fabricated from a fragment of tibial cortical bone osteokeratoprosthesis okp and can be.
The ookp is a toothalveolar boneperiosteum complex that forms a framework to house an optical cylinder, which acts as the artificial cornea. Mucosal complications in osteoodonto keratoprosthesis ookp. Pdf imaging of osteoodontokeratoprosthesis by electron. The role of visual evoked potential and electroretinography. The ookp lamina dimensions were measured on ebt and compared to the manual. To report the results of osteo odonto keratoprosthesis ookp surgery in patients who sustained severe chemical and thermal injuries methods.
To report the results of osteoodontokeratoprosthesis ookp surgery in patients who sustained severe chemical and thermal injuries. Jun 27, 2012 the revolutionary osteoodontokeratoprosthesis procedure, illustrated by stephen f. Osteo odonto keratoprosthesis is a multidisciplinary approach to restore vision for the patients with corneal blindness. An artificial cornea used as a last resource to restore vision to people whose corneas have been rendered opaque by dryeye disease or chemical injury that precludes successful corneal grafting. Keratoprosthesis surgery for endstage corneal blindness in asian eyes. For such cases, osteoodonto keratoprosthesis ookp which was first described by strampelli and later on modified by falcinelli et al and hull et al is a useful method for visual rehabilitation because of its higher retention rate and better longterm visual outcome. The ocular surface and how it can influence the outcomes. Keratoprostheses and artificial corneas springerlink. Sir, osteoodonto keratoprosthesis ookp, also known as tooth in eye surgery, is a unique form of artificial cornea surgery to. Of the original cohort, 181 patients 98 men and 83 women. Until now there has been no educational video for this complicated procedure. Tooth in eye surgery british dental journal nature. The osteokeratoprosthesis okp and osteoodontokeratoprosthesis ookp procedures replace the opaque cornea with a polymethylmethacrylate cylinder supported by a biological skirt the patients tibia or tooth root with its surrounding alveolar bone, respectively temprano 1993.
More recently, a less invasive, nonpenetrating artificial cornea has been developed which can be used in more routine cases of corneal blindness. It is a specialist surgical intervention that can restore meaningful vision to patients suffering from end stage corneal blindness, and for whom conventional corneal surgery is not possible for reasons such as severe dry eyes causing heavy scarring of the cornea. A noncomparative retrospective case series of 36 consecutive patients treated at the national ookp referral centre in brighton, uk, between november 1996 and march 2006. Apr 18, 2011 for such cases, osteo odonto keratoprosthesis ookp which was first described by strampelli and later on modified by falcinelli et al and hull et al is a useful method for visual rehabilitation because of its higher retention rate and better longterm visual outcome. Osteoodontokeratoprosthesis ookp surgery is a technique used to replace damaged. Objectiveto evaluate longterm anatomical and functional outcomes of a modified osteoodontokeratoprosthesis ookp technique for treatment of corneal. The window of the soul is our eye and the window of the eye is cornea. Since its discovery in the years of the french revolution, the field of keratoprostheses has evolved significantly. To report a successful osteoodonto keratoprosthesis. Recently, better outcomes have been achieved for these 2 devices mainly because of improvements in postoperative care and modifications in complication management through. Abstract the osteo odonto keratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage corneal blindness not amenable to penetrating keratoplasty.
Pdf on apr 9, 20, prof dr vineet vinayak and others published a tooth for an eye osteo odonto keratoprosthesis. Boston kpro i and osteo odonto keratoprosthesis ookp have the most favorable outcomes for their respective indications. Download fulltext pdf osteon odontokeratoprosthesis surgery article pdf available in british journal of ophthalmology 831. From the invention of dental cleaning tools to specialist procedures, innovation is always the best way to help serve the people. Osteo odonto keratoprosthesis ookp also known as tooth in eye surgery is a medical procedure to restore vision in the most severe cases of corneal and ocular surface patients.
Osteoodontokeratoprosthesis procedure, artwork by stephen f. In both cases, the mucosal graft was deemed to be too tight to accommodate the mookp implant. This was a retrospective analysis of patients who underwent ookp. Osteoodontokeratoprosthesis a maxillofacial perspective. Osteoodonto keratoprosthesis in stevensjohnson syndrome. Modified osteoodontokeratoprosthesis treatment mookp. Ophthalmology united states, mar 2008, 1153 p503510. Abstract the osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage corneal blindness not amenable to penetrating keratoplasty. An osteoodontokeratoprosthesis ookp procedure is indicated in patients with failed corneal transplant but having intact retina for visual improvement.
The osteoodontokeratoprosthesis to restore vision after severe. The keratoprosthesis with the best success rate till date is the osteo odonto keratoprosthesis ookp. It was developed some 40 years ago in italy and uses the patients own tooth root and alveolar bone to support an optical cylinder. The keratoprosthesis with the best success rate till date is the osteoodontokeratoprosthesis ookp. Keratoprosthesis can be divide into two broad categories.
Hearing about medical and dental advancements throughout the centuries is amazing. Modified osteoodontokeratoprosthesis treatment mookp in. A insertion of the optical cylinder through the tooth during the first step of an osteo odonto keratoprosthesis ookp implantation. Imaging of osteoodontokeratoprosthesis by electron beam. Clinical outcomes of boston keratoprosthesis and osteoodontokeratoprosthesis in severe ocular surface disease e.
Osteoodontokeratoprosthesis ookp is often the sole and last treatment option for visual rehabilitation in severe corneal blindness. The optical cylinder is cemented using pmma cement, ensuring that no cement is left on the visual surfaces of the optical cylinder. These figures are far below the survival rates of the osteoodontokeratoprosthesis. Modified osteoodontokeratoprosthesis for treatment of. Osteoodontokeratoprosthesis is a multidisciplinary approach to restore vision for the patients with corneal blindness. This is a complex artificial corneal surgical procedure that is performed in. Sir, osteoodonto keratoprosthesis ookp, also known as tooth in eye surgery, is a unique form of artificial cornea surgery to restore the vision of patients with the most severe. Osteo odonto keratoprosthesis ookp is a multistaged procedure for the treatment of blindness due to bilateral severe endstage corneal disease. Osteoodontokeratoprosthesis ookp is a complex artificial cornea keratoprosthetic surgical procedure in which a dental rootbone lamina and buccal mucosal graft are used to secure a clear acrylic optical cylinder in the anterior segment of the eye. This book covers the field of keratoprosthesis in detail and focuses specifically on the boston type 1 keratoprosthesis kpro, which is the device most widely used today.
More recently, a less invasive, nonpenetrating artificial cornea has been developed which can be used in more routine. Pdf a tooth for an eye osteo odonto keratoprosthesis. Glaucoma in modified osteoodontokeratoprosthesis eyes. The ookp lamina dimensions were measured on ebt and compared to the manual measurements at the time of surgery. It is an operation that restores vision in the most severe cases of corneal scarring. Note the difference in diameter between the anterior and the posterior segments. In the hope of rescuing her sight, she was referred for an osteoodontokeratoprosthesis ookp for her right eye. Osteoodontokeratoprosthesis ookp is a surgical procedure for replacing severe damaged corneas when corneal transplant is impossible and giving sight back. Osteoodontokeratoprosthesis in severe thermal and chemical. Developed by strampelli over fifty years ago and modified thereafter by falcinelli. Osteoodontokeratoprosthesis ookp is a technique used to replace damaged corneae in blind patients for whom cadaveric corneal transplantation is not an. Modified osteoodontokeratoprosthesis mookp what is it.
The psychosocial needs of patients undergoing ocular. Liu c1, paul b, tandon r, lee e, fong k, mavrikakis i, herold j, thorp s. The modified osteoodontokeratoprosthesis mookp procedure is performed to restore sight in endstage ocular surface disorders where conventional penetrating keratoplasty would have a high risk of failure. Stevensjohnson syndrometoxic epidermal necrolysis sjsten is a rare but severe and sometimes fatal condition associated with exposure to medications. The idea of using a tooth as a haptic for his new device was initially taken with skepticism by his contemporary colleagues. We sought to address the safety of acetazolamide, a chemically related compound, in patients with prior sjsten and glaucoma. In the hope of rescuing her sight, she was referred for an osteo odonto keratoprosthesis ookp for her right eye. Keratoprosthesis, boston keratoprosthesis, osteoodonto keratoprosthesis. Developed by strampelli over fifty years ago and modified thereafter by falcinelli, the ookp is by far t he only keratoprosthesis that has been retained in eyes for over twenty to thirty years. After removal, a lamina of tissue cut from the tooth is drilled and the hole is fitted with optics. Osteoodontokeratoprosthesis ookp is based on the principle of using the patients own tooth to form a biological frame to support an acrylic optical cylinder.
It includes removal of a tooth from the patient or a donor. Osteoodontokeratoprosthesis ookp or toothineye surgery, the original technique was described by benedetto strampelli nearly fifty years ago, using the patients own tooth root and alveolar bone as vital support to an optical cylinder, for patients with the most severe type of corneal and ocular surface diseases, for whom other treatments would not be useful. Traditionally, keratoprosthesis is recommended after a person has had a failure of one or more donor corneal transplants. However, the path towards its present state has not always been an easy one. Two young women with completely dry and keratinised eyes poststevens johnson syndrome sjs underwent unilateral oral mucous membrane grafts mmgs in preparation for modified osteoodonto keratoprosthesis mookp implantation. Extensive information is provided on all aspects of kpro surgery, from history and preoperative evaluation to surgical techniques and postoperative management of complications. The revolutionary osteoodontokeratoprosthesis procedure, illustrated by stephen f. Osteoodonto keratoprosthesis american academy of ophthalmology.
The optical cylinder and osteoodonto lamina are shown. Boston kpro i and osteoodontokeratoprosthesis ookp have the most favorable outcomes for their respective indications. Initially discarded for its devastating complications, the introduction of new materials and the discovery of antibiotics in the last century gave new life to the field. Osteo odonto keratoprosthesis ookp in 2016, dr webber became the first oral and maxillofacial surgeon in australia, and the southern hemisphere, to perform the surgical procedure known as osteo odonto keratoprosthesisookp or tooth in eye surgery. Recently, better outcomes have been achieved for these 2 devices mainly because of improvements in postoperative care and modifications in complication. Innovative dental and ophthalmic blending article pdf available in the journal of indian prosthodontic society 182 april 2018 with 74 reads how we measure reads. Seven patients with an ookp in one eye underwent ebt. To study the mucosal complications of osteoodonto keratoprosthesis ookp. Modified osteoodontokeratoprosthesis for treatment of corneal. Optical cylinder designs to increase the field of vision in the osteoodontokeratoprosthesis graefes archive for clinical and experimental opthalmology 2000. The most common indications for the procedure include chemical injuries and stevensjohnson syndrome sjs. To describe the experience of using electron beam tomography ebt in imaging of osteo odonto keratoprosthesis ookp to identify early bone and dentine loss which may threaten the viability of the eye. To present our experience in osteoodonto keratoprosthesis ookp as the only option to restore vision after severe ocular.
Keratoprosthesis is a surgical procedure where a diseased cornea is replaced with an artificial cornea. This is drilled and a plastic lens cemented into the hole. Pdf the osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for. This occurred despite treatment that included methylprednisolone, prednisolone, methotrexate, cyclosporine, dapsone, mycophenolate mofetil, intravenous immunoglobulins, and plasma exchange. Osteoodontokeratoprosthesis for endstage cornea blindness. Sir, osteoodonto keratoprosthesis ookp, also known as tooth in eye surgery, is a unique form of artificial cornea surgery. Among the different types of keratoprostheses, the modified osteoodontokeratoprosthesis mookp, which uses autologous tooth as a carrier for the polymethylmethacrylate optic, has shown promising longterm functional and anatomic results. B, removal of a corneal central fullthickness disc of a diameter corresponding to the polymethyl methacrylate optical cylinders intraocular diameter. A noncomparative retrospective case series of 36 consecutive patients treated at the national ookp referral centre in brighton, uk, between november 1996. Osteo odonto keratoprosthesis ookp gold coast oral. In 2016, dr webber became the first oral and maxillofacial surgeon in australia, and the southern hemisphere, to perform the surgical procedure known as osteo odonto keratoprosthesisookp or tooth in eye surgery. Visual rehabilitation in endstage inflammatory ocular.
To report the longterm results of osteoodontokeratoprosthesis ookp surgery in the visual rehabilitation of patients with corneal blindness from endstage inflammatory ocular surface disease. Download fulltext pdf osteonodontokeratoprosthesis surgery article pdf available in british journal of ophthalmology 831. Ebt in imaging of osteoodontokeratoprosthesis ookp to identify early bone and dentine loss which may threaten the viability of the eye. Objective to evaluate longterm anatomical and functional outcomes of a modified osteo odonto keratoprosthesis ookp technique for treatment of corneal blindness from various etiologies methods twohundred three patients 224 eyes underwent modified ookp surgery between 1973 and 1999. Modified osteoodontokeratoprosthesis mookp semantic scholar. To describe the experience of using electron beam tomography ebt in imaging of osteoodontokeratoprosthesis ookp to identify early bone and dentine loss which may threaten the viability of the eye. Oral acetazolamide after boston keratoprosthesis in. Keratoprosthesis kpro is the last resort for corneal blindness. Recent developments on osteo odonto keratoprosthesis ookp strampelli introduced for the first time in 1963 the socalled osteo odonto keratoprosthesis ookp. Osteoodontokeratoprosthesis ookp is a technique used to replace damaged corneae in blind patients for whom cadaveric corneal transplantation is not an option. Ookp procedure in a case of end stage of corneal blindness due to stevensjohnson syndrome. One step of the ookp consists of creating a precise hole into a tooth in which an optic cylinder is subsequently inserted.
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