Osteo-odonto-keratoprosthesis - a maxillofacial perspective.

Abstract

The OOKP (osteo-odonto-keratoprosthesis) is the treatment of choice for conditions like Stevens-Johnson syndrome, ocular cicatricial pemphigoid, trachoma, multiple failed grafts and chemical burns which are not amenable to penetrating keratoplasty. The OOKP is an autograft which replaces the cornea with a polymethacrylate cylinder mounted on a tooth-bone complex. The aim of this paper was to retrospectively analyze the records in 26 patients undergoing OOKP surgery between 2007 and 2011. The paper describes our experience with the procedure, with emphasis on its oral and maxillofacial aspects and management of associated complications. The aetiology of blindness in 23 patients was Stevens-Johnson's syndrome and chemical burns in three. Twenty-two patients had their maxillary canines, two had mandibular canines and two had maxillary first premolars as the choice of donor tooth. An oroantral fistula developed in four patients. One patient needed to undergo a surgical procedure for closure of the same. Roots of adjacent teeth were exposed in 12 patients. Twenty-four patients underwent both stages of the procedure with 19 being visually rehabilitated successfully. There was no improvement in the vision of four patients. One patient was lost to follow-up. Two patients have yet to undergo Stage 2.

• Authors: Vinod Narayanan, Natarajan Nirvikalpa, Srinivas K Rao
• Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 40 Issue 8 Pg. e426-31 (Dec 2012) ISSN: 1878-4119 [Electronic] Scotland
• PMID: 22425501 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Biocompatible Materials
• Polymethyl Methacrylate

Topics

• Adolescent
• Adult
• Aged
• Alveolar Process (transplantation)
• Bicuspid (transplantation)
• Biocompatible Materials (chemistry)
• Bioprosthesis
• Blindness (surgery)
• Burns, Chemical (complications)
• Cornea (surgery)
• Cuspid (transplantation)
• Eye Burns (complications)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Mouth Mucosa (transplantation)
• Ophthalmologic Surgical Procedures (methods)
• Oral Surgical Procedures (methods)
• Polymethyl Methacrylate (chemistry)
• Postoperative Complications
• Prosthesis Implantation (methods)
• Retrospective Studies
• Stevens-Johnson Syndrome (complications)
• Surgical Flaps
• Tissue and Organ Harvesting (methods)
• Tooth (transplantation)
• Young Adult