Blind patient regains sight with 'eyetooth' implanted in eye
9 October 2009
Blind for nine years, Sharron Kay Thornton has regained her sight
through a first-in-the-US surgical procedure at Bascom Palmer Eye
Institute at the University of Miami Miller School of Medicine. The
procedure — modified osteo-odonto-keratoprosthesis (MOOKP) — implanted
her eyetooth in her eye, as a base to hold a prosthetic lens.
“I’m looking forward to seeing my seven youngest grandchildren for
the first time,” said Thornton, 60, of Smithdale, Miss., who was blinded
by Stevens-Johnson syndrome in 2000. The rare, serious skin condition
destroys the cells on the surface of the eye causing severe scarring of
the cornea. “We take sight for granted, not realizing that it can be
lost at any moment,” she said. “This truly is a miracle.”
On Labor Day weekend, after the last in a series of surgeries by
corneal specialist Victor L. Perez, M.D., associate professor of
ophthalmology at Bascom Palmer Eye Institute, bandages were removed from
Thornton’s eyes and she was able to recognize faces only hours after her
surgery. Two weeks following her surgery, she is already reading
newsprint with a visual acuity of 20/70 and it is expected to improve
further as her surgical scars heal.
The steps in the modified
osteo-odonto-keratoprosthesis (MOOKP) in which an eyetooth is impalnted
in the eye as a base to hold a prosthetic lens
(Graphic: Business Wire)
“Through the work of Dr Perez’s team, patients in the United States
now have access to this complex surgical technique, which has been
available only in a limited number of centers in Europe and Asia,” said
Dr Eduardo C. Alfonso, MD, chairman of Bascom Palmer Eye Institute.
Developed in Italy, MOOKP has proven effective as a solution to
end-stage corneal disease where severe corneal scarring blocks vision
and corneal transplants are no longer an option but the eye’s internal
structures and optic nerve remain healthy. Patients may have suffered
trauma to their cornea, the outside surface of the eye where a contact
lens would sit, from chemical injuries, thermal burns, and inflammatory
or autoimmune disorders, such as Stevens-Johnson syndrome.
“For certain patients whose bodies reject a transplanted or
artificial cornea, this procedure ‘of last resort’ implants the
patient’s tooth in the eye to anchor a prosthetic lens and restore
vision,” explained Dr. Perez. “In Sharron’s case, we implanted her
canine tooth, her eyetooth.”
Dr. Perez’s interdisciplinary team included Yoh Sawatari, D.D.S.,
assistant professor of clinical surgery at the Division of Oral and
Maxillofacial Surgery and Dentistry at the University of Miami/Jackson
Memorial Medical Center, who extracted the patient’s canine or “eyetooth”
and surrounding bone.
In MOOKP, the tooth and surrounding bone are shaved and sculpted, and
a hole is drilled for the insertion of an optical cylinder lens. Next,
to bond the tooth and lens as a bio-integrated unit, they are implanted
under the patient’s skin in the cheek or shoulder. Meanwhile, the
ophthalmologist prepares the surface of the eye for implantation of the
prosthesis by removing scar tissue surrounding the damaged cornea.
About one month later, mucous material is collected from the inside
of the patient’s cheek and used to cover and rehabilitate the surface of
the damaged eye. In the final phase, usually two months later, the
prosthesis is removed from the cheek or shoulder and implanted in the
eye. The prosthesis is carefully aligned with the centre of the eye, and
a hole is made in the mucosa for the prosthetic lens, which protrudes
slightly from the eye and enables light to re-enter the eye allowing the
patient to see once again.
For Thornton, the surgery marked the successful conclusion of a
nine-year medical odyssey that started at the onset of Stevens-Johnson
syndrome.
Six years ago, a friend drove Thornton 900 miles to Bascom Palmer for
an ophthalmic evaluation. A stem cell procedure was performed, but
proved unsuccessful. Since she was not a candidate for a cornea
transplant, she was referred to Dr Perez, another Bascom Palmer surgeon
who was exploring the possibility of the MOOKP technique.
“I’m so thankful that the doctors at Bascom Palmer never gave up on
me – they kept searching,” said Thornton. Last year, Dr. Perez traveled
to Europe for training by Italian ophthalmologist Giancarlo Falcinelli,
M.D., who developed the MOOKP procedure, building on the original OOKP
technique developed in the 1960s by Professor Benedetto Strampelli,
M.D., also of Italy.
Now Thornton is excited about seeing her three grown children and
nine grandchildren — as well as rediscovering simple joys like watching
clouds and playing cards again with friends. “Without sight, life is
really hard. I’m hoping this surgery will help countless people,” she
said.
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