MODIFIED OSTEO-ODONTO-KERATOPROSTHESIS?: A NOVEL DENTAL AND OPHTHALMIC AMALGAMATION

The modified osteo-odonto-keratoprosthesis (MOOKP) is a biologic keratoprosthesis aimed to treat patients with corneal blindness caused by end-stage ocular surface diseases. MOOKP, also well known as- ?Tooth-in-eye surgery?, has proven to be the most effective therapeutic modality based on the number of patients who have undergone the procedure and the duration of documented follow-up. The original technique was described by Benedetto Strampelli and Prof.Giancarlo. Falcinelli has refined and improved this procedure, in a step wise manner. The procedure involves multiple stages, including the transplantation of buccal mucosa to the damaged ocular surface and the implantation of an osteo-odonto lamina with a mounted polymethylmethacrylate lens. Upon successful biointegration of the osteo-odonto lamina, the keratoprosthesis is able to resist resorption, provide stability, and prevent bacterial invasion and epithelial ingrowth. MOOKP surgery demands multidisciplinary team approach involving dentists and ophthalmologists. Possible complications of this procedure include ulceration of the implant buccal mucosa, ocular infection and secondary glaucoma. Nevertheless it has to be admitted that MOOKP surgery is extremely technique- sensitive and time consuming but however the results will be very satisfying and the patient may regain a quality of life that makes every effort for follow-up and treatment of unavoidable complications well worthwhile. This review article highlights the Modified Osteo-Odonto-Keratoprosthesis (MOOKP) indications, surgical Techniques, advantages and associated limitations