From Tooth to Vision: A Decade of Breakthroughs in Osteo-Odonto-Keratoprosthesis (OOKP) and Modified OOKP-Global Insights into Surgical Techniques, Outcomes, and Pioneering Research.

PURPOSE: Osteo-odonto-keratoprosthesis (OOKP), or "tooth-in-eye" surgery, is a pivotal technique developed for the treatment of severe corneal blindness in patients unsuitable for traditional corneal transplantation. This review aims to highlight the evolution, current advancements, and global adoption of OOKP, particularly for individuals with end-stage ocular surface disease.

METHODS

A comprehensive and systematic literature search was conducted across Embase, PubMed, Scopus, and Web of Science for articles published between 2014 and 2024, using the keyword search terms: "osteo-odontokeratoprosthesis" OR osteoodontokeratoprosthesis OR "osteo-odonto-keratoprosthesis" OR OOKP OR MOOKP.

RESULTS

OOKP remains uniquely effective for cases of severe ocular surface damage, including Stevens-Johnson syndrome and chemical or thermal burns. Long-term data demonstrate consistent visual rehabilitation and prosthesis retention across diverse populations in Europe, Asia, and South America. Advancements have improved tissue integration and reduced complications like graft resorption and secondary glaucoma. Innovations in surgical precision have further minimized tissue trauma and improved postoperative stability.

CONCLUSIONS

Despite its complexity, OOKP continues to evolve through surgical and material innovations, reflecting a sustained global commitment to improving visual outcomes in patients with otherwise untreatable corneal blindness. The continuous refinement of this technique holds promise for expanding its accessibility and success worldwide, paving the way for future advancements in keratoprosthesis surgery.