Osteo-Odonto-KeratoProsthesis (OOKP) Surgery at Farabi Hospital
The surgery was performed on a 43-year-old woman with bilateral corneal opacity and vision loss due to Stevens-Johnson Syndrome, a rare drug allergy. Preoperative examination revealed severe dry eye and adhesion of the eyelids to the corneal surface and keratinization of the corneal surface.
Natural corneal transplantation, as a method of treating a large part of the blindness caused by corneal opacity, is useless when there is severe eye dryness associated with eyelid damage, severe inflammation, blood vessels in the cornea, and a history of repeated graft rejection.
In these cases, there is no choice but to use artificial cornea. Even many types of artificial cornea cannot be used in these patients, and best surgery for patients with Stevens-Johnson Syndrome, ocular pemphigoid, chemical burns and severe trachoma is the use of Osteo-Odonto-KeratoProsthesis (OOKP) technique or dental-bone graft.
Dr. Zarei Ghanawati stated that artificial corneal transplantation using dental tissue is an advanced method for treatment of blindness in about 10 ophthalmology centers around the world, and Farabi Hospital was just added to the list of those centers performing this type of surgery.
Surgery is done in two stages, the first step is removing a canine tooth with some of the bone around it, and then cut it. Afterwards, a hole with a diameter of 3.5 to 4.5 mm is drilled into this cut, and special optical cylinder is inserted in it. This piece is implanted under the lower eyelid for three months until a vascular tissue is formed around it. Also, at this stage, the patient's cornea is covered with oral mucosal tissue.
In the second stage, the cornea and the tooth structure around which the connective tissue is grown will be removed by incision on the eyelid. Then, by making a cut in the center of the patient's cornea, some of the cylinder is inserted into the eye and the tooth and outer part of the cylinder are placed on the cornea and act as a corneal prosthesis.
The method was invented in the early 60s by the Italian ophthalmologist surgeon, Benedetto Strampelli; however, because of the difficulty and complexity of the method, few centers around the world perform this surgery.
It is worth mentioning that one of the most experienced surgeons in OOKP surgery is Professor Christopher Liu, who has worked hard to develop and train this technique in the world.
Dr. Zarei Ghanawati also said the cost of the surgery in the UK for the two stages of surgery was about £ 70,000 but no fee was taken from the patient.
We hope this surgery will bring hope and cure to many people in need of this operation, who live in Iran and neighboring countries.