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CS Liu, PP Syam, J Herold, CC Hull; Medium Term Visual and Retention Results of Modern Osteo-Odonto-Keratoprosthesis (OOKP) Surgery . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2994.
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Purpose: Falcinelli's modified OOKP technique has excellent long-term retention with 75% of patients seeing 6/12 or better. Our unit introduced this technique into Britain in 1996. We report our medium term visual and retention results. Methods: On going prospective study of patients receiving OOKP surgery at our unit. Results: 20 patients had multi-staged OOKP surgery completed from January 1997 to November 2001 (mean age 55.08 years; range 27-90 years). The mean follow up was 25.46 months (range 1-52 months). The pre-operative diagnoses were: Stevens Johnson syndrome (13), ocular cicatrical pemphigoid (3), alkali burn (2), trachoma (1) and radiation induced dry eye (1). Pre-operative visual acuities were PL (12), HM (7) and CF (1). Post-operative visual acuities were: 6/4 (1), 6/6(3), 6/9(3), 6/12(1), 6/18(1), 6/36(2), 1/18(1), CF (3), HM (3). 1 patient had her OOKP reversed due to previously undiagnosed severe macular scarring. 1 patient had his OOKP removed due to previously undiagnosed end stage glaucoma. Major complications were extrusion of the optical cylinder at 2 ½ years (1); retinal detachment (3); and retroprosthetic membrane formation (1). Conclusion: Our results confirm that OOKP is a valid technique for the corneal blind patient with a severe dry eye or keratinised ocular surface who are not amenable to conventional corneal transplantation. Accurate pre-operative diagnosis of pre-existing optic nerve or retinal problems will improve the visual outcome.
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