The osteo-odonto-keratoprosthesis (OOKP)

Christopher Liu*, Bobby Paul, Radhika Tandon, Edward Lee, Ken Fong, Ioannis Mavrikakis, Jim Herold, Simon Thorp, Paul Brittain, Ian Francis, Colin Ferrett, Chris Hull, Andrew Lloyd, David Green, Valerie Franklin, Brian Tighe, Masahiko Fukuda, Suguru Hamada

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

The osteo-odonto-keratoprosthesis (OOKP), although described over 40 years ago, remains the keratoprosthesis of choice for end-stage corneal blindness not amenable to penetrating keratoplasty. It is particularly resilient to a hostile environment such as the dry keratinized eye resulting from severe Stevens-Johnson syndrome, ocular cicatricial pemphigoid, trachoma, and chemical injury. Its rigid optical cylinder gives excellent image resolution and quality. The desirable properties of the theoretical ideal keratoprosthesis is described. The indications, contraindications, and patient assessment (eye, tooth, buccal mucosa, psychology) for OOKP surgery are described. The surgical and anaesthetic techniques are described. Follow-up is life-long in order to detect and treat complications, which include oral, oculoplastic, glaucoma, vitreoretinal complications and extrusion of the device. Resorption of the osteo-odonto-lamina is responsible for extrusion, and this is more pronounced in tooth allografts. Regular imaging with spiral-CT or electron beam tomography can help detect bone and dentine loss. The optical cylinder design is discussed. Preliminary work towards the development of a synthetic OOKP analogue is described. Finally, we describe how to set up an OOKP national referral center.

Original languageEnglish
Pages (from-to)113-128
Number of pages16
JournalSeminars in Ophthalmology
Volume20
Issue number2
DOIs
Publication statusPublished - 1 Apr 2005

Keywords

  • Allografts
  • Ciclosporin
  • Dry eye
  • Electron beam tomography
  • Keratoprosthesis
  • OOKP
  • Optics
  • Surgery

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    Liu, C., Paul, B., Tandon, R., Lee, E., Fong, K., Mavrikakis, I., Herold, J., Thorp, S., Brittain, P., Francis, I., Ferrett, C., Hull, C., Lloyd, A., Green, D., Franklin, V., Tighe, B., Fukuda, M., & Hamada, S. (2005). The osteo-odonto-keratoprosthesis (OOKP). Seminars in Ophthalmology, 20(2), 113-128. https://doi.org/10.1080/08820530590931386