Friday, November 22, 2024
11/22/2024
Project Summary: Osteo-odonto-keratoprosthesis (OOKP) or Tooth-in-Eye surgery is an exceptional procedure that can save severely injured corneas. The OOKP procedure is effective and capable of treating corneas after multiple corneal transplantation failures, or when the cornea is severely damaged by Stevens–Johnson syndrome, pemphigoid, chemical burns, trachoma and multiple corneal graft failure. The success rate in OOKP is high, however, it is an aggressive procedure, time consuming and involves partial sacrifice of the patient's oral cavity. This proposal aims to simplify this surgery by making a novel OOKP synthetic prosthesis. At the first stage of the OOKP surgery, a patient's tooth and surrounding tissue are harvested to make an autograft prosthesis called an osteo-odonto-lamina into which an optical cylinder is placed. This construct is then implanted into a submuscular pouch for 2–4 months to be vascularized. At the second stage of the surgery, the vascularized osteo-odonto-lamina is inserted into the eye to act as a frame for holding a PMMA optical cylinder. In this proposal, we build a special keratoprosthesis for the OOKP surgery as a replacement of the osteo-odonto- lamina so the surgeons do not need to harvest teeth and surrounding jawbone of the patients. For this purpose, we will follow the general design we have proposed in our recently issued patent. Although the design and idea of the keratoprosthesis have already been proposed in our patent, it has not been produced, and the details of the construct are yet to be configured in this proposal. More specifically, we are going to figure out the material, density, porosity, and pore-size of the different parts of the prosthesis in a way to mimic the details of the natural osteo-odonto-lamina structure, and particularly mimic the features of it that are accountable for the success of OOKP surgery. We will use a titanium alloy and 3D-printing technique to fabricate this keratoprosthesis. By considering our criteria for mimicking such construct, we will make 18 samples. They will go through a full physical, mechanical, and in vitro characterizations to find the most optimized synthetic OOKP keratoprosthesis. In sum, OOKP surgery is a multi-disciplinary, labor-intensive, and invasive procedure requiring both dental and ophthalmology expertise. Through the use of our new prothesis, the OOKP procedure can eliminate one very aggressive stage of the surgery that harms patients and can reduce the overall length of the treatment by a few months. It will considerably enhance the treatment of patients with severely injured corneas.
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