A man who lost his vision as a teenager two decades back, has regained sight in one eye after undergoing a rare surgical procedure, surgeryosteo-odonto-keratoprosthesis, also called “tooth-in-eye”. This surgery uses patient’s own canine tooth to support an artificial lens.
Brent Chapman, 34 of British Columbia (Canada), was 13 when he took ibuprofen during a Christmas basketball game. He had taken ibuprofen before, but this time he had a severe reaction and developed Stevens-Johnson syndrome. The condition caused burns across his body and as a result of his infection, he lost vision in his left eye and most of his vision in the other, according to the CNN report.
Stevens-Johnson syndrome, the rare and sometimes fatal drug reaction that caused Chapman’s blindness, causes severe inflammation of the skin and mucous membranes, including the eyes.
Chapman was in a coma for 27 days. He subsequently recovered from the body burns, but did not fully regain his vision.
Chapman underwent nearly 50 eye surgeries, including repeat cornea transplants over the past two decades to save his right eye, but in vain.
Before the tooth-in-eye surgery, Chapman was close to giving up hope. “For the last 20 years, I’ve been having close to 50 surgeries trying to save this eye, most of them cornea transplants,” Chapman said of his right eye. “We would put a new cornea in. It would last sometimes just a few months or even up to years, but it would just kind of never heal.”
But Dr. Greg Moloney, clinical associate professor of corneal surgery at the University of British Columbia, was able to restore Chapman’s sight with a rare procedure that involved implanting Chapman’s own tooth into his eye.
When the cornea is permanently opaque and the eye rejects a cornea transplant and as a last resort, surgeons sometimes turn to tooth-in-eye surgery or osteo-odonto-keratoprosthesis. This involves removing a patient’s tooth, sewing a piece of it into the cheek and placing the structure into their eye.
The surgery, which can take more than 12 hours across two stages, is rare and performed by only a handful of specialists worldwide. But for people who qualify – like Chapman, success can mean regaining nearly normal vision.
The procedure involves removing a canine tooth, which is the longest tooth in the human mouth, along with a thin layer of bone around the tooth that provides support and blood, keeping it alive. The tooth is then shaved into a 4 millimeter-thick block and drilled to hold a plastic optical cylinder, explained Dr. Ben Kang, Chapman’s oral maxillofacial surgeon and division head of Oral & Maxillofacial Surgery at Vancouver General Hospital.
The shaved tooth, with the lens in place, is implanted into the patient’s cheek for several months so tissue can grow around it. “The tooth is a really ideal structure…and the body accepts it because it’s part of its own,” Moloney told CNN.
The next step is to make a hole in the front of the patient’s eye to create space for the new complex.
Once the tooth-lens complex is integrated with living tissue, it is surgically attached to the front of the eye, replacing the damaged cornea’s function. Tissue from inside the patient’s mouth is used to cover the tooth part of the device, giving the new eye a pink shade. Light can then pass through the clear lens to the retina, enabling vision again, provided that everything behind the cornea, remains healthy.
Chapman’s tooth was extracted in February, and the structure was placed into his eye in June. His final operation, which straightened the lens to correct visual distortion, took place on August 5.
He was fitted with glasses on August 13 and now has 20/30 vision in his right eye, meaning he can see details at a distance of 20 feet that a person with perfect vision can see at 30 feet.
The first thing he saw after his surgery was the skyline from Dr Moloney’s 16th-floor office.
“It’s really indescribable, to be able to see the whole city and how there’s a whole world that’s just intersecting. When you’re blind or low-vision, you’re not seeing that, and you’re kind of in your head more. There’s a lot more mental chatter, and it can be difficult,” Chapman said. “Dr. Moloney and I made eye contact for the first time, and we both got quite emotional. I haven’t really made eye contact in 20 years.”
“We’ve been with him since he was a teenage boy. He’s waited till he’s 34 to get that,” Moloney said. “We’ve all waited a long time.”
Dr Moloney said Chapman’s case highlights how long-term blindness can be reversed in selected patients. “We’ve been with him since he was a teenage boy,” he said. “He’s waited till he’s 34 to get that. We’ve all waited a long time.”
Chapman, who is a massage therapist is looking forward to working again. He is also looking forward to traveling, with Japan being on the top of the list.
Above all, Chapman is excited to dream again and “to not be limited by the instability of this condition and be able to plan and think ahead.”
