Seeing Teeth: A Cure for Blindness?

Among my research of new and improving dental technologies, I stumbled upon a most inspiring story concerning a previously blind man who underwent a unique surgery to fix his sight. Due to the successful procedure, the 50-year old man regained enough of his vision to be able to recognize shapes and colors as well as count (using fingers) from a distance of two feet. I found this article fascinating, especially considering what kind of surgery he underwent, and how it was done. The procedure, Osteo-Odonto Keratoprosthesis (the final product is pictured to the left), is approximately a five month process requiring two surgeries and (in my opinion the worst part) the removal of a tooth. In slang terms it is often referred to as “Tooth-in-eye surgery,” needless to say it is much more complex than simply putting one’s tooth into their eye.

In order to better appreciate my stance on the surgery, one must first understand the complexities and stages of the process. One of the more interesting facts about the method is the numerous kinds of doctors and other medical professionals that are required to make it happen. Among the more prominent professionals are surgical ophthalmologists, oral and maxillofacial surgeons, anesthesiologists, radiologists, and psychologists. By all of these different doctors combining their expertise and knowledge, this complex surgery is able to take place. As further medical advances are made (like this surgery) I think that the medical world is beginning to see how interrelated the whole body is, and how understanding overall health is the key to curing certain ailments. Cooperation between different medical fields is a necessity for research and development, and it is reassuring to see that such unity is happening currently. Even more inspiring is the idea that research like this has created a way for those considered blind to see again.

The Osteo-Odonto Keratoprosthesis process is a very painstaking, involved endeavor. First, the patients must undergo a series of tests from an optometrist, or other eye-care professional, to determine the severity of their sight loss and if the procedure will help cure them. Typically, only those patients with sight loss due to corneal damage, and damage to their outer eyes and eyelids are appropriate candidates. If deemed healthy and able to undergo the process, the first surgery is performed. In the primary stage an anesthesiologist is used to put the patient to sleep in an operating room. From there, an eye surgeon will then work on the injured eye, or eyes, and remove the scar tissue from the eye injury, the inner surface of the eyelid, and the corneal surface. Then an oral surgeon removes part of the inner lining of the cheek, and together with the help of the eye surgeon, transplants this tissue to the new surface of the eye. This is one of the more proactive parts of the procedure as it has two different professionals working together to heal the same patient. After the transplant, the oral surgeon will remove a canine or first premolar tooth (if the canine teeth are unusable for one reason or another), as well as a part of the jaw and adjoining ligaments. This tooth is then modified by drilling, to fit a plastic optical device (somewhat resembling a bolt, seen left) which is cemented to the tooth. Once this is completed, the entire apparatus is implanted into the cheek so that it can grow a new blood supply. The patient is then stitched up and given four months for their body to heal before the second surgery.

The second surgery is the more delicate procedure in that it must be meticulously done. The first step is to have the eye surgeon open the cheek lining that was placed on top of the eye. The surgeon then creates a circular opening in the cornea of the eye, where the tooth will be implanted. While creating the hole, the surgeon will also remove the inner contents of the eye such as the vitreous humor, which would affect the ability of the tooth apparatus to focus light. The tooth device, which by now has blood vessels pumping into it, is removed from the cheek, and implanted within the eye. The final stage is to place the cheek lining that was originally covering the eye around the implant, and to suture it closed to seal the eye cavity. After a week of recovery, the patient is able to see again because light will pass through the new implant, and focus on the retina.

Overall, the surgery is considered successful by numerous reliable sources. Based on the results of patients who underwent the procedure in a collaborative effort by the Singapore National Eye Centre and the National Dental Centre of Singapore, 66% of patients had successful treatments resulting in perfect vision. The remaining patients who were able to see all fell well within the range of functional vision. In a more in depth study by the Wessex Institute of Technology in Great Britain, the long-term effects of the surgery were explored. Surprisingly, the majority of patients who had successful surgeries had minimal complications in the years following. Obviously, there is the risk of rejection of the tissue from the body, which is a common occurrence with tissue and joint replacement procedures; however this possibility is minimized by the development of antibiotics that help the body more easily accept the implants. In any case, the study found that complications such as glaucoma arose after 5 years of sight in some patients (less than 33%), and major complications that required removal of the implant only occurred in 3.5% of patients as soon as 12 years after the surgery and as late as 20. With technological advances and more medical research, a surgery this successful might become common place in the near future.

Finding this article is very inspiring for anybody who is interested in the healthcare profession. To see that surgeons are starting to find new ways to help people, and are branching out from the traditional methods is exciting to witness. This surgery is a leap in the right direction for medical professionals. The human body is extraordinary in what it is able to accomplish on a daily basis. While much research is pointed toward new technology, such as radiation therapy for cancer, and nanotechnology, I feel that it is equally important for research to be directed inward. If human beings can manufacture their own cure for blindness, it lends itself to the idea that the human body holds more keys to medical advances than was originally thought. For those aspiring to be a part of this era in discovery of the potential of the human body, it is an exhilarating time, and is only made better by discoveries such as Osteo-Odonto Keratoprosthesis.