Bascom Palmer performs first U.S. MOOKP procedure

The first modified osteo-odonto-keratoprosthesis (MOOKP), a procedure that involves implanting a tooth in the eye as a base to hold a prosthetic lens, has been successfully performed by Victor L. Perez, M.D., associate professor of ophthalmology at Bascom Palmer Eye Institute (Miami), the hospital said in a press release.

The 60-year-old patient had gone blind in 2000 as a result of Stevens-Johnson syndrome.

Dr. Perez noted that 2 weeks post-surgery, the patient is reading 20/70 and he expects her vision to continue to improve. 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, the hospital said. 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,” Dr. Perez said. “In [this patient’s] case, we implanted her canine tooth, her eyetooth.”

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 1 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 center 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, Bascom Palmer said.

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