Keratoprosthesis kpro is the last resort for corneal blindness. Osteoodontokeratoprosthesis definition of osteoodonto. Clinical sciences modified osteoodontokeratoprosthesis. A large osteodental lamina obtained by joining 2 laminae allowed the.
Insertion of the osteo odonto keratoprosthesis device requires a complex staged procedure, in which the cornea is. Osteoodontokeratoprosthesis ookp and the testing of. Relevant outcomes are change in disease status, morbid events, quality of life, and treatmentrelated morbidity. Osteo odonto keratoprosthesis ookp is a surgical technique created by dr. Laminar resorption in modified osteoodontokeratoprosthesis. The future of keratoprostheses artificial corneae article pdf available. Osteoodontokeratoprosthesis for endstage cornea blindness. Enhancement of bony ingrowth to metal implants by combining controlled. Pdf the osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage. A new vision through combined osteoodontokeratoplasty.
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 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. The window of the soul is our eye and the window of the eye is cornea. It is an operation that restores vision in the most severe cases of corneal scarring. Osteoodontokeratoprosthesis ookp is a surgical procedure for replacing severe damaged corneas when corneal transplant is impossible and giving sight back. Insertion of the ookp device requires a complex staged procedure, in which the cornea is first covered with buccal mucosa. The osteo odonto keratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of. 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 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. 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. Anatomically, the cornea is the outermost layer of the eye and is primarily responsible for light refraction which allows for central and peripheral vision.
Osteo odonto keratoprosthesis ookp is a technique used to replace damaged corneae in blind patients for whom cadaveric corneal transplantation is not an option. Osteonodontokeratoprosthesis surgery british journal. 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. After removal, a lamina of tissue cut from the tooth is drilled and the hole is fitted with optics. The preservation of the osteo odontolamina is the vital feature in maintaining the stability of the ookp. 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. 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.
Presently, there are three keratoprosthesis with a widespread use in humans. A, removal of the cheek mucosal graft covering the cornea and the flieringa ring. Amongthedifferentapproaches,one of the oldest, and probably most frequentlyusedsincethesixties,isthestrampelli3 osteo odonto keratoprosthesis ookp technique. Modified osteoodontokeratoprosthesis mookp is being performed more and more by surgeons. Osteo odontokeratoprosthesis ookp surgery is a technique used to replace damaged cornea in blind patients for whom cadaveric transplantation is not feasible. Osteoodontokeratoprosthesis ookp instructional video. The principle of ookp preparation is based on an optical cylinder intended to restore optical func. Boston kpro i and osteo odonto keratoprosthesis ookp have the most favorable outcomes for their respective indications. Modified osteoodontokeratoprosthesis mookp surgery. The ground electrode was positioned on the forehead. The ookp is a heterotopic autograft used for the treatment of severe corneal. Ookp surgery is a complex procedure requiring lifetime followup.
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. 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. Boston keratoprosthesis or equivalent devices such as. 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.
There are, however, some patients who are not amenable to such transplantation. Keratoprosthesis is a surgical procedure where a diseased cornea is replaced with an artificial cornea. Pdf the future of keratoprostheses artificial corneae. E ditor,we wish to point out some inaccuracies portrayed by the media on osteo odontokeratoprosthesis ookp surgery offered at our hospital. The keratoprosthesis replaces the section of cornea that has been removed, and, along with. Recent developments on osteo odonto keratoprosthesis ookp strampelli introduced for the first time in 1963 the socalled osteo odonto keratoprosthesis ookp. In the programme, the operation was described as new. It includes removal of a tooth from the patient or a donor. 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. 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. Pdf the osteoodontokeratoprosthesis ookp researchgate. This is drilled and a plastic lens cemented into the hole. Others combine stage 1b and 1c as a single procedure. Sir, osteo odonto keratoprosthesis ookp, also known as tooth in eye surgery, is a unique form of artificial cornea surgery to restore.
The role of visual evoked potential and electroretinography in the preoperative assessment of osteo keratoprosthesis or osteo odonto keratoprosthesis surgery. The osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage corneal blindness not amenable to penetrating keratoplasty. 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 gold coast oral. Osteoodonto keratoprosthesis ookp is a multistaged procedure for the treatment of blindness due. Osteo odonto keratoprosthesis ookp has been successfully used in diseases with severe ocular surface in. Modified osteoodontokeratoprosthesis for treatment of corneal. 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. 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. Biomechanical evaluation of different hydroxyapatite coatings on.
Insertion of the osteo odonto keratoprosthesis device requires a complex staged procedure, in which the cornea is first covered with buccal mucosa. In 1996, we performed our first ookp operation that was televised as a bbc tomorrows world programme. Corneal diseases are among the major causes of global blindness, secondary to cataracts. Cadaveric corneal transplantation is generally successful for reversing corneal blindness. 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. The idea of using a tooth as a haptic for his new device was initially taken with skepticism by his contemporary colleagues.
This paper keratoprosthesis ookp, which is a two stage procedure whereby dental and buccal tissue is auto transplanted into eye to serve as a. Wendy hamriding talks about osteo odonto keratoprothesis and how she can see for the first time in 2 years. 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. Keratoprosthetic devices consist of a central optic held in a cylindrical frame. Osteo odonto keratoprosthesis or toothineye surgery. B, removal of a corneal central fullthickness disc of a diameter corresponding to the polymethyl methacrylate optical cylinders intraocular diameter. The keratoprosthesis has been developed to restore vision in patients for whom a corneal transplant is not an option. Osteoodonto keratoprosthesis ookp for patients with. Traditionally, keratoprosthesis is recommended after a person has had a failure of one or more donor corneal transplants. 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 osteo odonto keratoprosthesis ookp.
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