"Tooth in the eye" refers to a surgical procedure called Osteo-Odonto-Keratoprosthesis (OOKP), also known as tooth-in-eye surgery. It's a complex, multi-stage procedure used to restore vision in patients with severely damaged corneas who are not suitable for a traditional corneal transplant.
Understanding Osteo-Odonto-Keratoprosthesis (OOKP)
OOKP utilizes the patient's own tooth and surrounding jawbone to create a biocompatible prosthetic for the eye. This minimizes the risk of rejection, which is a common concern in corneal transplants.
The OOKP Procedure: A Step-by-Step Overview
The OOKP procedure typically involves these stages:
- Tooth and Jawbone Extraction: A tooth (usually a canine or premolar) and a section of surrounding jawbone are removed from the patient.
- Prosthetic Fabrication: The extracted tooth and jawbone are prepared to create a frame that will support a synthetic optical cylinder (lens).
- Preparation of the Eye: The damaged cornea is removed, and the eye is prepared to receive the prosthetic. This sometimes involves preparing the inner cheek lining to be grafted onto the eye later.
- Implantation: The tooth-bone-lens prosthetic is implanted into the patient's eye. First, it may be implanted under the skin of the chest or abdomen for several months to develop a blood supply. Then, the prosthetic is removed from the chest or abdomen and implanted into the eye.
- Recovery and Monitoring: Extensive post-operative care and monitoring are crucial to ensure the success of the OOKP procedure and prevent complications.
Why Use a Tooth?
- Biocompatibility: The patient's own tooth and jawbone are highly biocompatible, which significantly reduces the risk of rejection by the body's immune system.
- Structural Support: The bone provides a strong and stable framework to hold the artificial lens.
Who is a Candidate for OOKP?
OOKP is generally considered for patients with:
- Severe corneal damage from chemical burns
- Stevens-Johnson syndrome
- Ocular cicatricial pemphigoid
- Other conditions where corneal transplantation has failed or is not possible
Risks and Complications
Like any surgical procedure, OOKP carries risks, including:
- Infection
- Glaucoma
- Retinal detachment
- Bone resorption
- Prosthetic extrusion
Despite the risks, OOKP offers a potential solution for restoring vision in cases where other treatments have failed.
