Boston kpro i and osteoodontokeratoprosthesis ookp have the most favorable outcomes for their respective indications. Osteo odonto keratoprosthesis is a technique designed for patients with severe corneal opacification who would be at high risk of graft rejection should donor tissue transplantation be performed. It was developed some 40 years ago in italy and uses the patients own tooth root and alveolar bone to support an optical cylinder. It is particularly resilient to a hostile environment such as the dry keratinized eye resulting from severe. Keratoprosthesis can be divide into two broad categories. 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 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. Traditionally, keratoprosthesis is recommended after a person has had a failure of one or more donor corneal transplants. This is drilled and a plastic lens cemented into the hole. Osteo odonto keratoprosthesis 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. Pdf the osteoodontokeratoprosthesis ookp researchgate. Modified osteo odonto keratoprosthesis technique step 2.
Osteoodonto keratoprosthesis is one of the most successful forms of keratoprosthesis surgery for endstage corneal and ocular surface disease. Insertion of the osteo odonto keratoprosthesis device requires a complex staged procedure, in which the cornea is first covered with buccal mucosa. Osteo odonto keratoprosthesis ookp is a technique used to replace damaged corneae in blind patients for whom cadaveric corneal transplantation is not an option. Osteoodonto keratoprosthesis ookp for patients with. Osteoodontokeratoprosthesis definition of osteoodonto. Full text is available as a scanned copy of the original print version. After removal, a lamina of tissue cut from the tooth is drilled and the hole is fitted with optics. Sir, osteo odonto keratoprosthesis ookp, also known as tooth in eye surgery, is a unique form of artificial cornea surgery. Osteo odonto keratoprosthesis ookp is based on the principle of using the patients own tooth to form a biological frame to support an acrylic optical cylinder. There are, however, some patients who are not amenable to such transplantation. Two case reports of an unusual orbital tumor and secondary infection in a patient with immunodeficiency are presented. Recent developments on osteo odonto keratoprosthesis ookp strampelli introduced for the first time in 1963 the socalled osteo odonto keratoprosthesis ookp.
Relevant outcomes are change in disease status, morbid events, quality of life, and treatmentrelated morbidity. Links to pubmed are also available for selected references. B, removal of a corneal central fullthickness disc of a diameter corresponding to the polymethyl methacrylate optical cylinders intraocular diameter. Two case reports of an unusual orbital tumor and secondary infection in a patient with immunodeficiency are presented with detailed clinical features and photographs. Modified osteoodontokeratoprosthesis for treatment of corneal. It appears that preservation of the alveolardental ligament plays a definitive role in the maintenance of the prosthesis. The preservation of the osteo odontolamina is the vital feature in maintaining the stability of the ookp. Pdf we report the first case of osteoodontokeratoprosthesis ookp who successfully underwent surgery in malaysia following a grade 4. 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. Corneal diseases are among the major causes of global blindness, secondary to cataract. 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. The osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage corneal blindness not.
Corneal blindness, the second most common human disability affecting a huge population 1. 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. Abstract the osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage corneal blindness not amenable to penetrating keratoplasty. Clinical sciences modified osteoodontokeratoprosthesis. 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. In surgical management of severe corneal scarring, the osteoodontokeratoprosthesis ookp according to strampelli is recognised as the. Osteoodontokeratoprosthesis ookp is a medical procedure to restore vision in the most. Comparison of candidate materials for a synthetic osteoodonto.
Insertion of the ookp device requires a complex staged procedure, in which the cornea is first covered with buccal mucosa. It is an operation that restores vision in the most severe cases of corneal scarring. In switzerland, the specialized teams at the university hospital of basel are focusing on the bonetoothcornea prosthesis method. Clinical assessment of bone loss can be useful of the cornea and evidence of previous corneal perfo but radiographs are essential. Indications for surgery, visual acuity, anatomical survival, complication and repeat surgery rates were compared among the different studies. Keratoprosthesis is a device intended to restore vision to patients with severe bilateral corneal disease. The ground electrode was positioned on the forehead. Osteonodontokeratoprosthesis surgery article pdf available in british journal of ophthalmology 831. The osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage corneal blindness not amenable to penetrating keratoplasty.
Osteoodontokeratoprosthesis ookp instructional video. Insertion of the osteo odonto keratoprosthesis device requires a complex staged procedure, in which the cornea is. Modified osteoodontokeratoprosthesis for treatment of. Osteo odontokeratoprosthesis ookp surgery is a technique used to replace damaged cornea in blind patients for whom cadaveric transplantation is not feasible. Improvement of the osteoodontokeratoprosthesis according to. 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. To study the results of the modified osteo odonto keratoprosthesis mookp surgery in bilateral endstage ocular surface disorders. All stakeholders and providers are part of the formal ookp team, described in the. A noncomparative retrospective case series of 36 consecutive patients treated at the national ookp referral centre in brighton, uk, between.
Amongthedifferentapproaches,one of the oldest, and probably most frequentlyusedsincethesixties,isthestrampelli3 osteo odonto keratoprosthesis ookp technique. The keratoprosthesis with the best success rate till date is the osteo odonto keratoprosthesis ookp. It is a specialist surgical intervention that can restore meaningful vision to patients suffering from end stage corneal blindness, and for whom conventional corneal surgery is not possible for reasons such as severe dry eyes causing heavy scarring of the cornea. Osteoodontokeratoprosthesis for endstage cornea blindness. Get a printable copy pdf file of the complete article 564k, or click on a page image below to browse page by page. Because of the isolation of the prosthetic implant from the tissues that the technique provides, the authors are of the opinion that it is the only viable option in such patients. Gingival disease with no bone loss can be easily cell failure, metaplasia, or dysplasia is noted. 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. Candidates for keratoprosthesis have conditions offering a low probability for success with a corneal transplantation e. The most common is the osteo odonto keratoprosthesis, which uses osteodental lamina derived from an extracted tooth root and attached alveolar bone that has been removed from the patients jaw. Osteoodontokeratoprosthesis ookp or tibiabone prosthesis tkpro a costs. Presently, there are three keratoprosthesis with a widespread use in humans.
The mookp surgery is performed as a routine in 3 stages. Visual rehabilitation in endstage inflammatory ocular. Osteoodontokeratoprosthesis a maxillofacial perspective. Pdf a tooth for an eye osteo odonto keratoprosthesis. Pdf the osteoodontokeratoprosthesis ookp, although described over 40 years ago, remains the keratoprosthesis of choice for endstage. Kunstliche hornhaut fur ultimaratiopatienten fraunhofer iap. Objectiveto evaluate longterm anatomical and functional outcomes of a modified osteoodontokeratoprosthesis ookp technique for treatment of corneal. Pdf osteoodontokeratoprosthesis for endstage cornea blindness. Bei patienten mit stark vaskularisierten hornhautnarben geht eine hornhauttransplantation mit einem hohen absto. The role of visual evoked potential and electroretinography in the preoperative assessment of osteo keratoprosthesis or osteo odonto keratoprosthesis surgery. Prepared osteoodontokeratoprosthesis with optic, still including crown of tooth, anterior view. A, removal of the cheek mucosal graft covering the cornea and the flieringa ring. Full text full text is available as a scanned copy of the original print version.
Ookp surgery is a complex procedure requiring lifetime followup. What links here related changes upload file special pages permanent link page. Case series on osteoodonto keratoprosthesis ookp published in english from 1950june 2010 were identified in medlinepubmed. 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. Keratoprosthesis is the osteoodonto keratoprosthesis ookp, which uses osteodental lamina derived from an. Osteo odonto keratoprosthesis ookp gold coast oral. Modified osteo odonto keratoprosthesis mookp what is it. The keratoprosthesis replaces the cornea that has been removed and is held in place by. Modified osteoodontokeratoprosthesis treatment mookp.
Clinical sciences modified osteoodontokeratoprosthesis for treatment of corneal blindness longterm anatomical and functional outcomes in 181 cases giancarlo falcinelli, md. Defintion keratoprosthesis is a surgical procedure where a severely damaged or diseased cornea is replaced with an artificial cornea to restore useful vision or. Pdf on apr 9, 20, prof dr vineet vinayak and others published a tooth for an eye osteo odonto keratoprosthesis. Final appearance of an osteoodonto keratoprosthesis. It includes removal of a tooth from the patient or a donor. Osteo odonto keratoprosthesis or toothineye surgery. More recently, a less invasive, nonpenetrating artificial cornea has been developed which can be used in more routine cases of corneal blindness.
Cadaveric corneal transplantation is generally successful for reversing corneal blindness. Osteoodontokeratoprosthesis ookp is a surgical procedure for replacing severe damaged corneas when corneal transplant is impossible and giving sight back. The ookp is a heterotopic autograft used for the treatment of severe corneal. Stage 1a involves removal of the iris and anterior vitrectomy with a corneal transplant if indicated. The histological features are reported of osteo odonto acrylic laminae removed from three patients who for differing underlying causes received strampellis osteo odonto keratoprostheses ook 20, 16, and 12 years previously. 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. To report the longterm results of osteo odonto keratoprosthesis ookp surgery in the visual rehabilitation of patients with corneal blindness from endstage inflammatory ocular surface disease. Keratoprosthesis is a surgical procedure where a diseased cornea is replaced with an artificial cornea.
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