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The Osteo-Odonto-Keratoprosthesis résumé of six-year operative experienceK. Hille1, H. Landau2, K. W. Ruprecht1
Purpose: In patients with severe corneal scarring and vascularisation a corneal graft has a high risk of failure. In those patients a Osteo-Odonto-Kerato-Prosthesis can be performed. We report about six years of surgical experience with this method.
Method:. We performed an OOKP in 8 patients with ocular pemphigoid, severe alkali burns and repulsion of a corneal graft respectively. Each of the patients had a insufficiency of the limbal stem cells, a severe vascularisation of the cornea and a visual acuity of finger counting or less. The osteo-odonto-keratoprosthesis consisted of a PMMA-cylinder of 8 mm length and a diameter from of 3 to 4 mm and of a root of a tooth of the patient. This was implanted in the cornea and covered with buccal mucosa.
Results: The longest follow up is 4 years in two patients with a medium of 2,5 years. The implants are well incorporated with a visual acuity between 0.1 and 0.9. The visual field is centred but 5 of 8 Patients had a vitreous bleeding after the operation that was spontaneously absorbed. Revision of the mucous coverage was necessary in 4 patients, one of them had a severe inflammation with absorption of the bone and tooth implant. One patient developed a secondary angle closure glaucoma and was treated successfully by implantation of an Ahmed Valve.
Conclusions: In severe corneal scars with neovascularisation the osteo-odonto-keratoprosthesis is still appropriate and shows good results in visual rehabilitation of patients with severe corneal scars.
1
Augenklinik, 2Mund-Kiefer-Gesichts-Chirurgische Abteilung, Universität des Saarlandes, Kirrberger Straße 1, D 66424 Homburg