At first glance, the phrase “tooth-in-eye” might seem like something that would destroy vision rather than save it. However, this “tooth-in-eye” actually refers to a procedure that’s been working eyesight-related miracles.
Using a tooth to restore vision might seem like a bizarre idea, but it really does work in these cases. A 34-year-old man from Canada is one of the most recent patients to receive this rare treatment.
“It kind of sounded a little science fictiony. I was like, ‘Who thought of this?’ Like this is so crazy,” said the North Vancouver, British Columbia, resident.
The patient
“It was quite emotional,” said Brent Chapman of making eye contact with Dr. Greg Moloney after the procedure this summer. “I hadn't really made eye contact in 20 years. It felt really euphoric. It was really fantastic.”
Chapman lost his vision at age 13, according to Today.com. It all started with a basketball tournament – he felt a bit ill at the game and took ibuprofen for pain relief.
Those pills caused an unexpected and life-threatening skin reaction known as Stevens-Johnson syndrome. Per the Cleveland Clinic, this is a very serious skin peeling condition caused by an allergic reaction.
As a result of the reaction, Chapman was in a coma for 27 days. He woke up with eyes his eyes still impacted by the ordeal. His left eye remains irreversibly blind, while his right eye sustained corneal damage.
For the past 20 years, Chapman has been trying to find a way to restore or preserve any vision he may have left. In that time, he’s had 10 cornea transplants. They have only worked for short periods of time.
“It was very devastating when I would lose that vision again, so we couldn’t keep going down that road,” Chapman explained, according to Today.com.
The doctors
During that time, Moloney had been researching ways to refine osteo-odonto-keratoprosthesis, also known as OOKP or tooth-in-eye surgery, said Providence Research. It said OOKP procedures have been performed since 1963 but they weren’t available in Moloney’s home country of Australia in the 2010s. Australians were travelling to Singapore to get the surgery done.
“Recognizing this unmet need, Dr. Moloney worked to organize the training, funding and resources necessary to enable the surgical program at Sydney Eye Hospital to conduct OOKP,” said Providence Research of the University of New South Wales graduate. “With the support of Dr. Konrad Hille, the lead surgeon in Germany’s OOKP program, he went on to conduct seven of these surgeries on patients in Australia.”
Moloney is now an ophthalmologist at Providence Health Care’s Mount Saint Joseph Hospital (MSJ) in Vancouver. He’s also a Clinical Associate Professor in the Department of Visual Sciences at the University of British Columbia (UBC). When he was recruited to join UBC in 2021, his goal was to establish the first Canadian tooth-in-eye clinic.
“Usually, the reaction is shock and surprise and frank disbelief that it even exists,” Moloney said.
Dr. Ben Kang, an oral surgeon, was also part of the process to preserve Chapman’s eyesight. He conducted the first procedure.
The process
Readers might be wondering how exactly a tooth could restore vision. Providence Research explained that the tooth serves as a “uniquely durable” frame for a lens that can help patients see. If other types of material are used, the implant might be rejected by the body. When someone’s own tooth is used, the immune system is less likely to treat it as a threat.
“Although we would like a less invasive option for this category of patient, nothing has presented itself that has the same long-term durability and visual outcomes that this procedure does,” said Moloney.
To start things up, Kang removed one of Chapman’s upper canine teeth in February. He had to select a healthy, robust tooth that could hold the lens, the oral surgeon told Today.com.
After removing the tooth, Kang shaped and flattened it with a drill. One it was shaped, he drilled a hole in the center for the lens.
Then, the tooth was implanted not into Chapman’s eye, but first into a fat pocket under his eye for three months. This allowed his body to grow tissue around it. Moloney eventually stitched it to the front of Chapman’s right eye.
While one of the complications of the surgery has been reabsorption of the tooth by the body, Moloney said that his team as tracked that issued and developed alterations. It is also rather complicated and resource-intensive, per Providence Research.
The outcome
Unlike when he awoke from his coma all those years ago, Chapman woke up from his tooth-in-eye surgery with immediately improved vision, Today.com reported. At first, he could see hand movements and within months, his vision began to sharpen.
“We tried some glasses and I had this moment where I was like, wow, OK, I’m really seeing well now,” Chapman said of his vision after the surgery.
Now, he has around 20/40 or 20/30 vision in his right eye, according to Moloney. Chapman wears sunglasses to deal with some glare, but that hasn’t stopped him from reading, walking without a cane and even playing basketball again. He calls the experience “life changing.”
Ideal patients for the procedure have a healthy “back of the eye” – that means that they have a healthy optic nerve and retina despite corneal damage. Studies show that the lens is functional for around 30 years in 90% of cases – for Chapman that likelihood is around 50%.
Other successes
There has already been anther tooth-in-eye success story in Canada this year, according to Providence Research. In the U.S., a Mississippi woman underwent the procedure in 2009. Today.com the reported that “the Bascom Palmer Eye Institute in Miami says it’s the only center in the U.S. that performs the surgery.”