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Post Info TOPIC: A TOOTH FOR AN EYE:


Senior Member

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Date: Tue Feb 7 10:57 AM, 2006
A TOOTH FOR AN EYE:
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 THE USE OF  OSTEO-ODONTO KERATOPROSTHESIS (OOKP)FOR ENDSTAGE CORNEAL DISEASES


State of the Art the Osteo-Odonto Keratoprosthesis : Prof. DONALD TAN


Retinal Aspects of OOKP surgery : Dr. DORIC WONG


Glaucoma Problems and Solutions in OOKP patients : Prof. AUNG TIN


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The management of severe ocular surface inflammatory diseases and end-stagedry eye disorders such as Stevens Johnson syndrome, ocular cicatricial pemphigoid, and chemical burns remains difficult. Despite many advances in corneal and limbal stem cell transplantation, long term survival and visual rehabilitation in these patients remain bleak.


The Osteo-Odonto Keratoprosthesis (OOKP) is a form of artificial cornea or keratoprosthesis surgery designed to treat the most severe end stage corneal and ocular surface dry eye states.


 First introduced in the 1960s by Strampelli, recent modifications to the procedure have now shown excellent rates of retention and good visual outcomes, without severe complications of corneal melting, extrusion, retroprosthetic membrane formation and endophthalmitis normally associated with other forms of keratoprosthesis. OOKP surgery involves a radical two-stage procedure in stage 1, an autologous canine tooth is removed, modified to receive an optical PMMA cylinder, and then implanted into the cheek. At the same time, the corneal and conjunctival ocular surface is denuded and replaced with a full thickness buccal mucosal graft. Stage 2 surgery, performed 2-4 months later, involves retrieval of the tooth-cylinder complex and implanting it into the cornea, after lifting of the buccal mucosal flap, corneal trephination, iris and lens removal and anterior vitrectomy. Concurrent glaucoma and vitreoretinal procedures are also performed at this stage if required. In February 2004, the Singapore National Eye Centre embarked on its OOKP program, in collaboration with the National Dental Centre. We have now performed OOKP surgery on 13 patients, 12 of whom have completed Stage 2 surgery, with the longest follow-up being 16 months. To date, no keratoprosthesis complications have occurred. 5 patients have attained 6/6 vision, 4 have attained vision between 6/9 and 6/18 (2 eyes had retinal detachment), 2 eyes with glaucomatous optic neuropathy have attained 6/60 and 6/120 and the remaining eye has CF vision at one week. OOKP surgery appears to be a highly promising procedure which has the potential to restore excellent vision to the most severe cases of end-stage corneal disease, when all else has failed. Longer follow-up of these cases is currently underway.



-- Edited by Vikram at 11:10, 2006-02-07

-- Edited by Vikram at 07:12, 2006-02-09

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Anonymous

Date: Thu Feb 9 3:35 AM, 2006
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Hi Vik,


What do you mean by the title of the link? Also I think your post is in the wrong section... but it don't really matter...


Anyway I think they use this method as the very last resort to save someone's sight, if a transplant can not be done for what ever reason... (in the article you posted they talk of other conditions other than KC... and theses conditions may be more harder to treat with a transplant?)


Having said that all, read this topic its about using this method on earlier stages of KC...


http://www.activeboard.com/forum.spark?forumID=48159&subForumID=141495&action=viewTopic&commentID=3531467&topicPage=



-- Edited by QuintriX at 03:40, 2006-02-09

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Senior Member

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Posts: 107
Date: Thu Feb 9 7:20 AM, 2006
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i was going through an article in Indian Ophthamological Association where i found this article which is done at endstage  cornea  on outcome of chemical burns or damaged eye . where there is severe dryness


it was not linked directly to kc , the reason i did not post on above headings



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