Osteo-odonto-keratoprosthesis: From Tooth to Eye

A surgical procedure that involves grafting a tooth into the eye may sound unusual and intriguing, yet it is not impossible. According to Mousa (2025), the Osteo-odonto-keratoprosthesis (OOKP), often referred to as “tooth-in-eye surgery,” is a complex and highly specialized ophthalmological procedure designed to restore vision in patients. This surgery was first performed during the early 1960s in Rome by the Italian ophthalmic surgeon Professor Benedetto Strampelli (Wikipedia contributors, 2025). This surgery is typically performed in cases where patients’ have severe corneal blindness, making them unsuitable candidates for traditional corneal transplantation. 

According to McManes (2024), the ideal candidates for this surgery are patients who suffer from bilateral end-stage Ocular Surface Disease, where bilateral refers to both eyes and end-stage indicates that blindness has developed. This disease can occur when the cornea and conjunctiva (parts of the ocular surface) are damaged. As listed by Mousa (2025), OOKP may also be an option for patients with: 

• Stevens-Johnson Syndrome (SJS)

• Ocular Cicatricial Pemphigoid 

• Chemical Burns

• Severe Aniridia-related Keratopathy

The “tooth-in-eye” prosthetic cornea is a small, cylinder-shaped optical device made from a transparent synthetic polymer. This surgery involves removing a tooth along with some surrounding bone to construct the OOKP. It is crucial to select the right tooth to extract. Typically, a canine tooth is chosen because it has a stronger and more substanstial root than other teeth; the bone supporting the canine is also more robust, providing greater stability. 

Following this, the OOKP lamina must be constructed. The first step in this process is to extract the tooth and a portion of its adjacent bone. This extracted segment is then cut lengthwise and polished into a flat plate, known as a lamina. An incision is carefully made in the center of the lamina to hold the optical cylinder. The artificial cornea is finally secured inside the hole with medical cement. Before placing the OOKP in the eye, it must first be implanted into the patient’s cheek for about three months. During this time period, the body nourishes the tooth and bone, allowing blood vessels and tissue to grow around it. This ensures that the body will accept the implant. 

Finally, the eye must be prepared to receive the implant. First, the surgeon gently lifts a protective layer of tissue from the surface of the eye. Then, they make a small incision in the center of the cornea to remove the iris, lens, and some of the vitreous gel, gel-like fluid inside the eye. Afterwards, the OOKP is taken from the patient’s cheek and placed into the eye. The back part of the artificial cornea fits into the opening, while the tooth-and-bone lamina sits on the eye’s surface. The lamina is then stitched in place, and a small incision is made in the graft to allow the front part of the artificial cornea to show through. Finally, the graft is repositioned and stitched over the prosthetic, securing it in place. 

Advancements in surgical technologies and bioengineering will continue to improve these surgical procedures, making them more accessible and offering innovation, as well as providing the gift of sight to those who need it most.

Written by Sophia Perez at Incisionary

APA References

Mousa, A. (2025, February 4). Osteo-Odonto-Keratoprosthesis: An Overview. Journal of the Foundations of Ophthalmology. https://jfophth.com/osteo-odonto-keratoprosthesis-an-overview/

McManes, A. (2024, May 14). Tooth in Eye Surgery. All About Vision. https://www.allaboutvision.com/treatments-and-surgery/vision-surgery/corneal/tooth-in-eye-surgery/

Wikipedia contributors. (2025, March 25). Osteo-odonto-keratoprosthesis. Wikipedia. https://en.wikipedia.org/wiki/Osteo-odonto-keratoprosthesis

Mayo Clinic. (2025, April 30). Steven-Johnson Syndrome - Symptoms & Causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/stevens-johnson-syndrome/symptoms-causes/syc-20355936