Is a synthetic lamina the ultimate goal for osteo-odonto-keratoprosthesis (OOKP) surgery? Options for the edentulous patient who require OOKP surgery

Purpose To list the options for an edentulous patient requiring OOKP surgery for rehabilitating corneal blindness. Methods Literature review, personal experience, and theoretical considerations. Results Options include an OOKP allograft from a living (related or unrelated) donor which necessitate systemic immunosuppression, a tibial bone allograft (depends on good bone density), and a Pintucci (Dacron) keratoprosthesis. None of these has the longevity of an OOKP proper. Other options, as yet not properly studied, include cadaveric OOKP allografting, and synthetic OOKP analogues. The latter has the advantage of the possibility of mass manufacture, no risk of transmission of blood-borne infections, and no size constraints limiting optical cylinder design. Conclusion Options do exist for the edentulous patient requring OOKP surgery for rehabilitation of corneal blindness. In the long term, the synthetic OOKP analogue holds the best promise.