Perhaps you have heard about this amazing procedure which recently helped a Miami woman regain her lost eyesight. A prosthetic lens was inserted into a tooth that was removed from the patient, and then implanted into the eye. The surgical technique, modified osteo-odonto keratoprosthesis (MOOKP), has proven effective in cases where severe corneal scarring blocks vision, but the eye remains healthy. Has anyone heard of this before? Thoughts or comments? From CNNhealth.com photo credit: Rich Phillips/CNN
If the animation is accurate, the endodontist in me is of course wondering what they do about the canal space and tissue? Or do they take a small enough section to eliminate the main canal? In short, how do they eliminate the risk of infection from necrotic tissue?
From Bascom Palmer Eye Institute Press Release:
“For certain patients whose bodies reject a transplanted or artificial cornea, this procedure ‘of last resort’ implants the patient’s tooth in the eye to anchor a prosthetic lens and restore vision,” explained Dr. Perez. “In Sharron’s case, we implanted her canine tooth, her eyetooth.”
Dr. Perez’s interdisciplinary team included Yoh Sawatari, D.D.S., assistant professor of clinical surgery at the Division of Oral and Maxillofacial Surgery and Dentistry at the University of Miami Miller School of Medicine, who extracted the patient’s canine or “eyetooth” and surrounding bone. In MOOKP, the tooth and surrounding bone are shaved and sculpted, and a hole is drilled for the insertion of an optical cylinder lens. Next, to bond the tooth and lens as a bio-integrated unit, they are implanted under the patient’s skin in the cheek or shoulder. Meanwhile, the ophthalmologist prepares the surface of the eye for implantation of the prosthesis by removing scar tissue surrounding the damaged cornea.
About one month later, mucous material is collected from the inside of the patient’s cheek and used to cover and rehabilitate the surface of the damaged eye. In the final phase, usually two months later, the prosthesis is removed from the cheek or shoulder and implanted in the eye. The prosthesis is carefully aligned with the center of the eye, and a hole is made in the mucosa for the prosthetic lens, which protrudes slightly from the eye and enables light to re-enter the eye allowing the patient to see once again.
Tried to do a little quick research. The protocol may vary, but it appears as though they want the tooth to become covered in soft tissue before implanting it. Perhaps this will increase the stability.
"The modified OOKP (MOOKP) is basically a 2-step procedure. The first stage involves removal of the patient's canine tooth, and it is designed to hold the lens. Next, the tooth is paced in a pocket, which is created under the skin of the normal eye. A small piece of mucous membrane is than removed from the inside of the cheek and attached to the sclera of the injured eye. Five-months later, the second stage of the operation is performed. By now, the tooth, which is covered by soft tissue is removed from the pocket under the normal eye and placed behind the mucous membrane of the damaged eye, such that only the lens protrudes out of the eye."
From Squidoo.
I read about the procedure with temporary implantation of the tooth in shoulder first. What I couldn't find was an explanation of why the tooth was used and why it was implanted first in the shoulder and later in the eye.
Comments
This animation helped clarify the basic technique:
http://medweb02.med.miami.edu/bascom/mookp352x280.mp4
If the animation is accurate, the endodontist in me is of course wondering what they do about the canal space and tissue? Or do they take a small enough section to eliminate the main canal? In short, how do they eliminate the risk of infection from necrotic tissue?
From Bascom Palmer Eye Institute Press Release:
“For certain patients whose bodies reject a transplanted or artificial cornea, this procedure ‘of last resort’ implants the patient’s tooth in the eye to anchor a prosthetic lens and restore vision,” explained Dr. Perez. “In Sharron’s case, we implanted her canine tooth, her eyetooth.”
Dr. Perez’s interdisciplinary team included Yoh Sawatari, D.D.S., assistant professor of clinical surgery at the Division of Oral and Maxillofacial Surgery and Dentistry at the University of Miami Miller School of Medicine, who extracted the patient’s canine or “eyetooth” and surrounding bone. In MOOKP, the tooth and surrounding bone are shaved and sculpted, and a hole is drilled for the insertion of an optical cylinder lens. Next, to bond the tooth and lens as a bio-integrated unit, they are implanted under the patient’s skin in the cheek or shoulder. Meanwhile, the ophthalmologist prepares the surface of the eye for implantation of the prosthesis by removing scar tissue surrounding the damaged cornea.
About one month later, mucous material is collected from the inside of the patient’s cheek and used to cover and rehabilitate the surface of the damaged eye. In the final phase, usually two months later, the prosthesis is removed from the cheek or shoulder and implanted in the eye. The prosthesis is carefully aligned with the center of the eye, and a hole is made in the mucosa for the prosthetic lens, which protrudes slightly from the eye and enables light to re-enter the eye allowing the patient to see once again.
"The modified OOKP (MOOKP) is basically a 2-step procedure. The first stage involves removal of the patient's canine tooth, and it is designed to hold the lens. Next, the tooth is paced in a pocket, which is created under the skin of the normal eye. A small piece of mucous membrane is than removed from the inside of the cheek and attached to the sclera of the injured eye. Five-months later, the second stage of the operation is performed. By now, the tooth, which is covered by soft tissue is removed from the pocket under the normal eye and placed behind the mucous membrane of the damaged eye, such that only the lens protrudes out of the eye."
From Squidoo.