Modified osteo-odonto keratoprosthesis--the Indian experience--results of the first 50 cases.
OBJECTIVE
To study the results of the modified osteo-odonto keratoprosthesis (MOOKP) surgery in bilateral end-stage ocular surface disorders.


METHODS
The MOOKP surgery is performed as a routine in 3 stages. Stage 1A involves removal of the iris and anterior vitrectomy with a corneal transplant if indicated. Stage 1B + 1C usually performed simultaneously involves harvesting the buccal mucosa and transplanting it onto the ocular surface along with fashioning of the osteo-odonto alveolar lamina. Stage 2 involves transplanting the osteo-odonto alveolar lamina to the eye 3 months later.


RESULTS
The MOOKP surgery was completed in 50 eyes of 47 patients with a mean follow-up of 15.38 months (range: 1-54 months). Anatomic success was achieved in 96% of the eyes. Functional success of visual acuity > or = 20/60 was noted in 66% of eyes. Complications included oroantral fistula (6%), trophic mucosal alterations (8%), lamina exposure (central 6% and peripheral 8%), mucous membrane overgrowth (2%), hypotony (2%), expulsion of optic cylinder (4%), endophthalmitis (2%), glaucoma (20%), sterile vitritis (6%), and retinal detachment (2%).


CONCLUSIONS
MOOKP is the keratoprosthesis of choice in bilateral end-stage ocular surface disorders in the Indian subcontinent. Complications do occur and have to be recognized and treated early.
Iyer
Geetha
G
Corneal Service, Medical and Vision Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Pillai
Vinay S
VS
Srinivasan
Bhaskar
B
Falcinelli
Giovanni
G
Padmanabhan
Prema
P
Guruswami
Sitalakshmi
S
Falcinelli
Giancarlo
G
D000328:Adult; D000539:Alveolar Process / Q000637:transplantation*; D002057:Burns, Chemical / Q000601:surgery; D003315:Cornea / Q000601:surgery*; D003316:Corneal Diseases / Q000601:surgery*; D005126:Eye Burns / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D013262:Stevens-Johnson Syndrome / Q000601:surgery; D014092:Tooth Root / Q000637:transplantation*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult