Indeed, the 60-year-old grandmother from Mississippi was incredulous when broached about becoming the first recipient of a modified osteo-odonto-keratoprosthesis (MOOKP) in the United States. But now, just three weeks after surgery, she boasts 20/60 vision in her left eye, making her a believer in miracles, and a beacon of hope for patients around the world blinded by severe corneal scarring.
Osteo-Odonto-Keratoprosthesis Surgery (OOKP): This staged surgical technique utilizes the individual's own tooth root and alveolar bone to support an optical cylinder which is implanted in the person's cheek in the first stage procedure for a period of months while the new blood supply is established. In the second stage, the tooth/bone cylinder is removed from the cheek and inserted into the eye as a corneal implant. This complex surgical procedure is proposed as an alternative treatment for end-stage corneal blindness which is not amenable to penetrating keratoplasty (corneal transplant).
For individuals who have corneal blindness and have failed or are not candidates for corneal transplantation who receive an osteo-odonto-keratoprosthesis (OOKP), the evidence includes case series and a systematic review. Relevant outcomes are change in disease status, morbid events, quality of life, and treatment-related morbidity. A 2012 systematic review of case series, all conducted outside of the United States, found high anatomic survival rates at 5 and 20 years, but vision outcomes were not well-described. OOKP is a complex surgical procedure and has been associated with a number of complications, including extrusion of the keratoprosthesis, retinal detachment, and vitreoretinal complications. The evidence is insufficient to determine the effects of the technology on health outcomes.