The cornea is the clear dome-shaped part of the eye that protects it and plays a crucial role in focusing to create vision. When there is any form of intense damage to this part of the eye, a surgery is the best bet to regain near normal eyesight. However, the transplant can fail in some cases.
Over the years, there have been people who have actually tried traditional corneal transplant surgeries and the surgery has failed. For the longest of times, these people had little to no hope of seeing again until the introduction of the tooth in eye surgery (osteo-odonto-keraprosthesis–OOKP). The name of the surgery pretty much gives it away.
The tooth in eye surgery is a complex two phase procedure that restores vision to a functional level. The procedure is used to tackle severe corneal blindness where traditional corneal transplants have failed.
A number of things can lead to irreversible corneal damage some of which include: trauma, autoimmune diseases, chemical burns and Stevens-Johnson syndrome.
The very first attempt at this surgery was pioneered by an Italian ophthalmic surgeon, Benedetto Strampelli in the early 1960’s. This surgeon developed this innovative surgical approach to restore vision in patients with severe corneal damage and this has since been the foundation for the ground breaking modern osteo-odonto-keraprosthesis(MOOKP) .
Similar surgeries have been tried in the past using different materials and different approaches but they either failed or didn't have long lasting results (unlike the MOOKP that can last for years and even a lifetime) because the human body recognizes and rejects foreign materials/bodies.
Two Phases of The Surgery
As mentioned earlier, the surgery is in two phases separated by several months.
—The first phase of the surgery involves:
the extraction of the eye tooth(the canine) and properly shaping it.
drilling a hole into the canine and placing a plastic lens in the hole.
placing the canine into the cheeks(or the eyelids in some cases) to promote vascularization.
–The second phase of surgery happens after a few months and it involves:
the removal of the vascularized tooth
implantation of the tooth(new cornea) into the eye or eyes as the case may be. This lens now allows light to pass to the retina, allowing vision provided the retina and the optic nerves are still healthy.
The implant acts as a durable, biological artificial cornea. A combination of both phases of the surgery can last up to 12 hours in total.
After the implantation comes rehabilitation.
The surgery has been successfully performed in Australia, Canada, Europe, Asia and South America. You can only imagine how many people have successfully regained their sight.
The use of the patient's tooth minimizes the risks of rejection and graft failure. However, damage to the teeth and jaw during extraction, corneal perforation, damage to salivary glands, necrosis, severe infection or inflammation of the eye, glaucoma, retinal detachment amongst others are some of the possible risks that can accompany this procedure.
Be that as it may, I believe this isn't just a life changing procedure for those with corneal damage but a fusion between the dental and ophthalmic specialties. Make me hopeful for the future of medicine and science as a whole.