September 21st, 2009


Weird Ophthalmic Surgical Procedure

A co-worker forwarded this to me in email. Once I began reading, the idea entered the "WTF?!" realm. Very fascinating, but you have to wonder how someone came up with this idea in the first place. Sort of like toad-licking....

Rare Surgery Restores Sight

FRED TASKER. McClatchy Newspapers

MIAMI - A 60-year-old woman blind for nine years has regained useful
vision following a rare operation in Miami in which surgeons removed one of her
teeth, drilled a hole in it, inserted a plastic lens into the hole and
implanted the tooth-lens combination into her eye. It's the first such operation
in the United States, they said.

With 20/70 vision now, Sharron "Kay" Thornton, of Smithdale, Miss., can
recognize faces and read a newspaper with a magnifying glass, and should
get better vision once she is fully healed and fitted with glasses, doctors say.

"We're excited. We believe a lot of patients can benefit from this," said
Dr. Victor Perez, cornea specialist at Bascom Palmer Eye Institute of Miami,
where the procedure was performed.

Thornton lost her vision nine years ago to Stevens-Johnson syndrome, a
severe allergic reaction to medication that blistered and scarred her
cornea, the convex part of the eye that covers the iris and pupil. She wasn't a
candidate for a corneal transplant or an artificial plastic lens because
the eye was too badly damaged, Perez said. A stem cell procedure attempted six years
ago also failed.

Then she was referred to Perez, also an associate professor of
ophthalmology at the University of Miami Leonard M. Miller Medical School, for what he
calls a "procedure of last resort. He recently trained in Rome under Italian
ophthalmologist Giancarlo Falcinelli, who developed a modified version
of the tooth-lens procedure invented by another Italian doctor, Benedeteo Strampelli.

Unique use of eyetooth

Strampelli developed the procedure in 1963, but it didn't catch on for
decades because of serious complications at one point, including the
tooth-lens combination falling out of the eye.

But with Falcinelli's modification, the procedure is spreading in Europe
and Japan, and, now, in the United States. In Ireland, a worker's sight was
restored after his cornea was destroyed by red-hot liquid aluminum in an
explosion at a recycling plant.

The procedure is called a modified osteo-odonto-keratoprosthesis.
Outside experts agree the operation is a first in the United States.

It can be argued that this is suitable for the most severe of cases, in
which the patient has completely dry eyes," said Dr. Claes Dohlman,
cornea specialist at the Massachusetts Eye and Ear Infirmary, a teaching hospital of
Harvard Medical School. In those cases, [the procedure] has a reputation for
long-term stability.

In the Miami operation, Thornton's eyetooth was chosen because it had a
good amount of jawbone and ligament attached, both crucial for it to stay
alive and heal into the eye after being implanted, Perez said. The eyeteeth,
sometimes called canines, get their name because they sit in the mouth
directly beneath the eyes.

Many steps in process

The multistage procedure began when Dr. Yoh Sawatari, a dental surgeon
at the University of Miami/Jackson Memorial Medical Center, extracted
Thornton's eyetooth, shaved it flat horizontally, drilled a hole in it and inserted
an acrylic lens. He implanted the tooth-lens prosthesis under the skin
beneath the clavicle at the top of her shoulder for three months so the
combination could heal together.

Meanwhile, an eye surgeon removed scar tissue lining her damaged cornea.
A month later, surgeons removed a patch of skin from the inside of her
cheek and laid it over her cornea to replace the moist tissue lost to the disease.

Two months after that, Perez extracted the tooth-lens combination from
her shoulder, cut a flap out of the skin over the center of her cornea, cut
a hole down into the eye and inserted the tooth-lens. He sewed the flap shut to
hold in the prosthesis and cut a tiny hole so the lens can protrude a
couple of millimeters out of the eye.

On Labor Day weekend, bandages were removed and Thornton was able to
recognize faces within two hours.

Thornton now is looking forward to seeing her three grown children and
nine grandchildren for the first time in nine years.

Perez believes the patient's prognosis is good. "If there isn't any
infection, I'm optimistic we can preserve at least 20/70 vision for the
next 10 years."

* * *

My comment--That's an awful lot of surgery to go through. I'd have to devote considerable thought to the number of procedures and the expense before I'd consider it. On the other hand, just about anyone who loses their vision is often willing to go to extensive lengths to restore it.
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