Press Releases & Archive

31 July 2004

OSTEO – ODONTO KERATOPROSTHESIS - 'TOOTH IN EYE SURGERY'

Eye surgeons from the Singapore National Eye successfully completed the second stage of a revolutionary two stage surgical procedure to help a blind boy to see. This is believed to be the first operation of its kind in South-East Asia.

The patient, Luck Pewnual, a 19 year-old boy from Thailand, completely lost his sight in both eyes six years ago from a rare allergic reaction. Today, his sight has been restored, and he is now able to see with very good vision.

OOKP consists of 2 complex surgical procedures. Stage 1 of the surgery which was performed in the Singapore National Eye Centre in February involved 5 separate procedures, and surgical teams from SNEC and the National Dental Centre (NDC):

1.	opening up one eye and removing the entire inner surface of his eyelids, his corneal surface, and all scar tissue from his previous eye injury
2.	removing the inner mucosal lining of the cheek and transplanting it onto the new surface of the eye
3.	removing a canine tooth and part of the adjacent bone and attached ligaments from his jaw (interestingly, the canine tooth is also known as the “eye-tooth”)
4.	fashioning a bolt-shaped structure from this tooth-bone complex to receive a plastic optical cylinder which is cemented into place
5.	implanting the tooth-bone-cylinder complex into his cheek to grow a new blood supply

Stage 2 involved 2 separate procedures. First, the cheek mucosal lining over the eye was opened, and a circular opening made in his cornea to receive the implant. The inner front contents of the eye (iris, lens and anterior vitreous) was also removed at the same time.

Secondly, the living tooth-bone-cylinder complex was removed from the cheek, examined for viability, trimmed and placed within the cornea, and the mucosal cheek lining replaced over the implant. At the end of the procedure, light can now enter through the plastic cylinder.

This second stage procedure was performed on 5 June, and after the operation, Luck’s vision has steadily improved. Yesterday, minor eyelid surgery and a final surgical adjustment was made to this implant, and today, Luck is able to see through this cylinder with very good vision. He has attained 6/12 vision, enough to be able to legally drive a car, and also has excellent vision for reading.

OOKP surgery is a last ditch attempt for those who lose their sight when their corneas and front part of the eye and eyelids are severely damaged. Patients selected for surgery will include those cases of complete blindness in which conventional corneal transplants will not work.

We have since also successfully performed Stage 1 surgery on a local patient, and several other patients will be lined up in the near future.

For further information, please contact:
Ravi Chandran
Public Relations Department
Singapore National Eye Centre
Tel: 6322 8394
E-mail: ravi@snec.com.sg

The Surgical Team involved in Stage 2

1. OOKP Surgeons:

Assoc Prof Donald Tan Deputy Director, Singapore National Eye Centre (SNEC) Head and Senior Consultant ,Corneal & External Eye Disease Service, SNEC Director, Singapore Eye Research Institute Head, Dept of Ophthalmology, National University of Singapore Dr Julian Theng Consultant, Corneal & External Eye Disease Service SNEC

2. OOKP Anaesthetist

Dr V Sivagnanaratnam Visiting Consultant Anaesthetist, SNEC Emeritus Consultant Anaesthetist, Changi General Hospital

3. SNEC Corneal Fellows, Corneal Nurses and OT Nurses