OOKP SURGERY
 
 
(Osteo -Odonto Keratoprosthesis,  or "Tooth-In-eye" Surgery)    
            
                                                             Giving Sight To The Blind
  
    Above is the logo I drew myself for OOKP Surgery, and is copyright. W.Adams 2003.  
My Story  
 
 
OOKP Surgery (Tooth In Eye Surgery)
Because I have this one retina, I was fortunate indeed to become a candidate for OOKP Surgery in 2003. This operation is performed by Mr. Christopher Liu Consultant Ophthalmologist Honorary Clinical Senior Lecturer & Consultant Ophthalmic Surgeon; Research Lead in Ophthalmology, BSUH, at Sussex Eye Hospital Brighton, in the United Kingdom. See a recent documentary film  (Oct 2013) concerning OOKP surgery in which I feature speaking about blindness and my own OOKP surgery........
Click on the pink arrow to play, but if  a Parental Guidance Lock appears, check the box asking if you are over 16 and click the long button saying "Play content without turning on parental guidance lock" and it will play.

Mr .Liu performs pioneering surgery called Osteo-Odonto Keratoprosthesis (OOKP) or "Tooth-in-eye" surgery, and it takes place over two operations or stages.
Quote from link below....
 
Osteo-odonto-keratoprosthesis (OOKP) surgery is a technique used to replace damaged corneae in blind patients for whom cadaveric corneal transplantation is doomed to failure. It is the treatment of choice for patients with end stage inflammatory corneal disease, and in the case of a severe dry eye, due to loss of production of tears, no other device will work nearly as well.
 
Patients with bilateral corneal blindness resulting from severe end-stage Stevens-Johnson syndrome, ocular cicatricial pemphigoid, (NB: Indistinguishable from IgA  mediated bullous disease, when affecting these tissues)  chemical burns, trachoma, dry eyes or multiple corneal graft failure may be considered for OOKP surgery.
The field of vision is limited and will not satisfy the legal requirements for driving in the UK and some other countries.
 
The eye in which the prosthesis has been implanted will not look like a normal eye and will still impact on their social interactions, particularly with strangers. The prosthesis needs careful attention and follow-up and its vulnerability will preclude them from activities with a high risk of contact or contamination.

The assessment of a patient referred for consideration of OOKP surgery warrants special attention, because of the nature of the treatment and the nature of the population group for whom it is considered. Almost without  exception, patients being considered for OOKP surgery will have had years of poor sight and so are at an increased risk of psychopathology. In fact, most have also undergone multiple procedures, disappointments and years of emotional stresses but, nevertheless, may have become well adjusted to their predicament.
 
As is the case for any surgical procedure, the potential patient must appreciate the risks involved and have a realistic appreciation of the potential benefits. However, candidates for OOKP surgery must also understand that the formation of an osteo-odonto-keratoprosthesis involves multiple operations, usually over a period of months and sometimes years.
During that time there will be multiple hospital admissions and follow-up visits and there are likely to be setbacks along the way, which may or may not be readily rectifiable. The patient must also appreciate the significant financial, time and emotional stresses that they, and those close to them, will encounter.

Stage 1.... One of my lower canine teeth was harvested with the gum below it, and this was put into a "pocket" made under the eye not being used for the prosthesis, and stitched up for 2-3 months to vascularise.(become vascular and have vessels that circulate fluids). Bucca mucosa harvested from the inside of my cheek, was then stitched over the eye to be operated on, and stitched into place under the lids. It too would gain a blood supply over the next 2-3 months.
Read Stage 1 on page 5 of 16 in this link.
 
Stage 2...The second operation involves opening the "pocket" containing the tooth and gum, releasing it, and to inspect it. It is left there ready, until it is required. The Bucca Mucosa stitched over the eye to be operated on, is cut away from the lower lid, and away from covering the eye, until it can be peeled back like a flap, still joined under the top lid. The eye is deflated, a hole made right through the heavily scarred tissues. A hole is made in the tooth to support a perspex optic cylinder which is then cemented into place. It is placed and cemented into the scarred tissue of the eye, which is then re -inflated . The flap of Bucca Mucosa is pulled back over the top , and a hole made in it so that the optic pops through like a button through a buttonhole. It is then stitched again as before, under the lower lid.
Read Stage2 of the Surgery in this link again on page 6 of 16.
 
 
 
 
 
At 1.45pm on Friday Feb.14th 2003, I was able to see again! Less than 36 hours after my second stage operation! If I had been standing in Heaven, it could not have felt better than it did that day! Words cannot describe to anyone how wonderful it is to see one's children and family again, and to see and to appreciate what a beautiful world we live in.
At present 2008, I have 6/4 vision, can read the bottom line on the eye chart with distance glasses, and read the smallest print available with reading glasses. (10's) I can draw and paint again and spend hours in my own personal library and study. Alas! I can no longer drive as I have only 70% field of vision and 120 % is required to keep a licence. This is the case for all OOKP patients.
 
I have recently learned that my scans show bone loss but the rim (hole holding the optic in the tooth) is intact. See page 11 of 16 in link below which shows a tooth in situ, and then in another patient, bone loss, and a close up of that scan.

Feb 14th 2003 is my re-birth day! because that is how it felt; and my family and friends celebrate it every year, all thanks to this wonderful , wonderful man , (who should be in my opinion, Knighted for his work and dedication to the people not only from the UK, whom he has brought back from a living hell. 
 
 
Mr. Christopher Liu