Visual rehabilitation in end-stage inflammatory ocular surface disease with the osteo-odonto-keratoprosthesis: results from the UK

Abstract

OOKP surgery can restore useful and lasting vision in patients suffering from end-stage ocular surface disease, for whom conventional corneal surgery is not possible. The main problems seen in this study were laminar resorption, particularly in allografts, and glaucoma.

Cost effectiveness of the type II Boston keratoprosthesis

“…[5][6][7][8] In contrast, several manuscripts have described the modified osteoodontokeratoprosthesis as efficacious in this patient population. [9][10][11] For many, this represents the gold standard for severe ocular surface disease. Nevertheless, the morbidity and postoperative complications associated with this lengthy, two-stage procedure, 11 and the possibility for a more simplistic and pragmatic KPro cannot be ignored, especially as recent modifications to the type II design and postoperative management of patients have led to improved clinical outcomes.…”

“…[9][10][11] For many, this represents the gold standard for severe ocular surface disease. Nevertheless, the morbidity and postoperative complications associated with this lengthy, two-stage procedure, 11 and the possibility for a more simplistic and pragmatic KPro cannot be ignored, especially as recent modifications to the type II design and postoperative management of patients have led to improved clinical outcomes. 12,13 To determine cost effectiveness by way of cost-utility analysis (CUA), the perceived value of an intervention or health state is taken into account.…”

Modified Osteo Odonto Keratoprosthesis (MOOKP) - "Tooth For An Eye"

“…First, the addition of holes (at present 16 holes) in the back plate allows diffusion of nutritive aqueous to support donor graft stroma and keratocytes Second, in 2004, a titanium locking c-ring was added to prevent intraocular disassembly of the device. Third, in 2007, the design was changed from a threaded (screwtype) assembly to a threadless design which simplified assembly and produced less damage to the donor endothelium [10]. The most recent advance in design is the implementation of a titanium back plate which likely improves biocompatibility and retention, and may reduce complications such as retroprosthetic membranes (RPM) and stromal corneal melts [11].…”

Apatite Deposition on NaOH‐Treated PEEK and UHMWPE Films for Sclera Materials in Artificial Cornea Implants

“…Semi-synthetic KRPOs, known as osteo-odontokeratoprosthesis (OOKP), also exist which use an autologous tooth to form the skirt. [23][24][25] As already mentioned above, in the last two decades various problems with the tissue integration of synthetic KPROs have been reported, including poor tissue integration between the artificial implant and the host cornea, resulting in infection and/or inflammation and eventual extrusion of the implant. [5] More specifically, a poor interface seal between optic and skirt can lead to epithelial down-growth, aqueous leakage, [11] and formation of a retrocorneal membrane behind the optic, thus, leading the afore-mentioned extrusion of the implant.…”

“…[11,26,27] These problems are the result of the inability of recipient cells (epithelial cells and keratocytes) to colonize the optic. [10,11] In contrast, the OOKP has shown good long term success with the implant retained (success rate of 85% in 18 years) [23,25] despite 10% retinal detachment. The OOKP, however, provides only a limited vision.…”