Osteoodontokeratoprosthesis for endstage cornea blindness. Pdf the osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage. Osteo odonto keratoprosthesis 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. Osteoodonto keratoprosthesis ookp is a multistaged procedure for the treatment of blindness due. Osteoodonto keratoprosthesis ookp for patients with. Osteoodontokeratoprosthesis ookp and the testing of. Enhancement of bony ingrowth to metal implants by combining controlled.
Summary the osteo odonto keratoprosthesis is the procedure of choice for rehabilitation of corneal blindness for endstage ocular surface disease, serving a completely different patient group to. In 1996, we performed our first ookp operation that was televised as a bbc tomorrows world programme. The osteo odonto keratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of. The osteo keratoprosthesis okp and osteo odonto keratoprosthesis 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. The idea of using a tooth as a haptic for his new device was initially taken with skepticism by his contemporary colleagues. Osteo odonto keratoprosthesis or tooth for an eye 23 is a complex 2 stage procedure in which the canine tooth or any single root tooth is removed from the patients mouth. Abstract the osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage corneal blindness not amenable to penetrating keratoplasty.
The ground electrode was positioned on the forehead. Osteo odonto keratoprosthesis ookp gold coast oral. Pdf the osteoodontokeratoprosthesis ookp researchgate. Traditionally, keratoprosthesis is recommended after a person has had a failure of one or more donor corneal transplants.
The principle of ookp preparation is based on an optical cylinder intended to restore optical func. The keratoprosthesis replaces the section of cornea that has been removed, and, along with. Modified osteo odonto keratoprosthesis mookp for patients over 18 years of age with end stage sjs with severe keratinization of ocular surface and 0 schirmerss not amenable to other ocular surface reconstructive procedures, in patients who have a suitable canine tooth. The role of visual evoked potential and electroretinography in the preoperative assessment of osteo keratoprosthesis or osteo odonto keratoprosthesis surgery. The keratoprosthesis has been developed to restore vision in patients for whom a corneal transplant is not an option. Osteonodontokeratoprosthesis surgery british journal.
A new vision through combined osteoodontokeratoplasty. E ditor,we wish to point out some inaccuracies portrayed by the media on osteo odontokeratoprosthesis ookp surgery offered at our hospital. Biomechanical evaluation of different hydroxyapatite coatings on. Osteo odontokeratoprosthesis ookp surgery is a technique used to replace damaged cornea in blind patients for whom cadaveric transplantation is not feasible. Recently, better outcomes have been achieved for these 2 devices mainly because of improvements in postoperative care and modifications in complication management through years of experience and. A, removal of the cheek mucosal graft covering the cornea and the flieringa ring. Med j malaysia vol 66 no 4 october 2011 369 osteoodontokeratoprosthesis for endstage cornea blindness h s wong, k y then, r ramli department of ophthalmology, department of oral and maxillofacial, university kebangsaan malaysia medical centre, jalan. Modified osteoodontokeratoprosthesis mookp surgery. Defintion keratoprosthesis is a surgical procedure where a severely damaged or diseased cornea is replaced with an artificial cornea to restore useful vision or to make the eye comfortable in painful keratopathy. Osteoodontokeratoprosthesis a maxillofacial perspective. Recent developments on osteo odonto keratoprosthesis ookp strampelli introduced for the first time in 1963 the socalled osteo odonto keratoprosthesis ookp. Insertion of the ookp device requires a complex staged procedure, in which the cornea is first covered with buccal mucosa.
Insertion of the osteo odonto keratoprosthesis device requires a complex staged procedure, in which the cornea is first covered with buccal mucosa. The preservation of the osteo odontolamina is the vital feature in maintaining the stability of the ookp. The ookp is a heterotopic autograft used for the treatment of severe corneal. Osteo odonto keratoprosthesis ookp or toothineye, originated by prof benedetto strampelli in italy in 1960s, is a procedure which aims at sight restoration for patients with the most severe type of corneal and ocular surface diseases, for whom other treatments would not be useful. This is drilled and a plastic lens cemented into the hole. Modified osteo odonto keratoprosthesis technique step 2. Boston kpro i and osteo odonto keratoprosthesis ookp have the most favorable outcomes for their respective indications.
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. Modified osteoodontokeratoprosthesis mookp is being performed more and more by surgeons. Anatomically, the cornea is the outermost layer of the eye and is primarily responsible for light refraction which allows for central and peripheral vision. There are, however, some patients who are not amenable to such transplantation. B, removal of a corneal central fullthickness disc of a diameter corresponding to the polymethyl methacrylate optical cylinders intraocular diameter. The most common is the osteo odonto keratoprosthesis, which uses osteodental lamina derived from an extra cted tooth root and attached alveolar bone that has been removed from the patients jaw. It includes removal of a tooth from the patient or a donor. Keratoprosthetic devices consist of a central optic held in a cylindrical frame. Ookp technique is a complex artificial corneal keratoprosthetic transplantation procedure in which an autologus dental rootbone lamina complex and buccal mucosal graft are used to mount a polymethylmethacrylate. This necessitated a carrier for the artificial cornea that would reduce the incidence of complications encountered with the other types of keratoprosthesis namely extrusion, foreign body reaction and risk of infection liu et al. The future of keratoprostheses artificial corneae article pdf available.
Pdf the future of keratoprostheses artificial corneae. After removal, a lamina of tissue cut from the tooth is drilled and the hole is fitted with optics. Boston keratoprosthesis or equivalent devices such as. Laminar resorption in modified osteoodontokeratoprosthesis. Mookp is a procedure where the team of surgeons will extract a canine tooth of the patient as insert a lens into the dentin of the tooth. Osteo odonto keratoprosthesis or toothineye surgery. Others combine stage 1b and 1c as a single procedure. Cadaveric corneal transplantation is generally successful for reversing corneal blindness. It was developed some 40 years ago in italy and uses the patients own tooth root and alveolar bone to support an optical cylinder.
Keratoprosthesis is the osteo odonto keratoprosthesis ookp, which uses osteodental lamina derived from an extracted tooth root and attached alveolar bone that has been removed from the patients jaw. Presently, there are three keratoprosthesis with a widespread use in humans. Relevant outcomes are change in disease status, morbid events, quality of life, and treatmentrelated morbidity. It is an operation that restores vision in the most severe cases of corneal scarring. Ookp surgery is a complex procedure requiring lifetime followup. Osteoodontokeratoprosthesis definition of osteoodonto. The assessment of a patient referred for consideration of ookp surgery warrants special attention, because of the nature of the treatment and the nature of the population group for whom it is considered. Modified osteoodontokeratoprosthesis for treatment of. Corneal diseases are among the major causes of global blindness, secondary to cataracts. Osteoodontokeratoprosthesis ookp is a surgical procedure for replacing severe damaged corneas when corneal transplant is impossible and giving sight back. Osteoodontokeratoprosthesis ookp instructional video. Keratoprosthesis can be divide into two broad categories.
Clinical sciences modified osteoodontokeratoprosthesis. Osteo odonto keratoprosthesis ookp is a surgical technique created by dr. The window of the soul is our eye and the window of the eye is cornea. Insertion of the osteo odonto keratoprosthesis device requires a complex staged procedure, in which the cornea is. The osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage corneal blindness not amenable to penetrating keratoplasty. The keratoprosthesis with the best success rate till date is the osteo odonto keratoprosthesis ookp.
Amongthedifferentapproaches,one of the oldest, and probably most frequentlyusedsincethesixties,isthestrampelli3 osteo odonto keratoprosthesis ookp technique. A large osteodental lamina obtained by joining 2 laminae allowed the. In the programme, the operation was described as new. Keratoprosthesis kpro is the last resort for corneal blindness.
Modified osteoodontokeratoprosthesis for treatment of corneal. More recently, a less invasive, nonpenetrating artificial cornea has been developed which can be used in more routine cases of corneal blindness. 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 keratoprosthesis ookp or tooth in eye surgery. Osteo odonto keratoprosthesis ookp is a technique used to replace damaged corneae in blind patients for whom cadaveric corneal transplantation is not an option. Osteo odonto keratoprosthesis ookp has been successfully used in diseases with severe ocular surface in.
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