Osteo-odonto-keratoprosthesis: a surgical procedure for treating advanced corneal diseases

Corneal blindness remains a significant challenge in modern ophthalmology, accounting for 12% of global blindness cases. While corneal transplantation is often an effective treatment, its success is limited in patients with severe ocular surface diseases such as Stevens-Johnson syndrome, trachoma, or autoimmune-related dry eye disease. For these patients, osteo-odonto-keratoprosthesis (OOKP) has emerged as a highly specialized surgical solution, utilizing a patient's tooth as a scaffold for an artificial cornea, providing long-term visual restoration. This article traces the historical evolution of keratoprostheses, beginning with early 19th-century attempts at artificial cornea implantation to the modern Rome-Vienna protocol of OOKP. The surgical procedure is outlined from both ophthalmological and surgical perspectives, detailing key modifications, such as complete removal of the iris and lens, use of custom-made optical cylinders, and advanced biocompatible materials. These improvements have significantly enhanced the stability and longevity of the procedure while reducing the risk of complications such as glaucoma, inflammation, and implant rejection. A systematic review of scientific literature was conducted, analyzing 39 sources primarily obtained from PubMed. Researchers carefully selected these articles based on their abstracts to ensure relevance, providing a comprehensive analysis of OOKP.This article highlights its role as an advanced alternative for treating end-stage corneal blindness, offering hope to patients who are not candidates for conventional corneal transplantation. Osteo-odonto-keratoprosthesis (OOKP) is an innovative method for restoring vision in patients with severe corneal damage, significantly improving their quality of life. While the procedure presents challenges and risks, many individuals who undergo OOKP regain the ability to see and regain independence. Technological advancements should focus on refining the technique, minimizing complications, and increasing its accessibility. Additionally, patient education and support are crucial for successful rehabilitation and adaptation. OOKP is a remarkable achievement in medicine and biomedical engineering, offering hope to patients and inspiring further research to enhance the quality of life for people worldwide.