MIAMI - A 60-year-old woman blind for nine years has regained useful vision after a rare operation in Miami in which surgeons removed one of her teeth, drilled a hole in it, inserted a plastic lens into the hole and implanted the tooth-lens combination into her eye.
It's the first such operation in the United States, they said.
With 20/70 vision now, Sharron "Kay" Thornton of Smithdale, Miss., can recognize faces and read a newspaper with a magnifying glass, and should get better vision once she is fully healed, doctors say.
Thornton lost her vision nine years ago to Stevens-Johnson syndrome, a severe allergic reaction to medication that blistered and scarred her cornea, the convex part of the eye that covers the iris and pupil. She wasn't a candidate for a corneal transplant or an artificial plastic lens because the eye was too badly damaged, said Dr. Victor Perez, a cornea specialist at Bascom Palmer Eye Institute of Miami, where the procedure was performed. A stem cell procedure attempted six years ago at Bascom Palmer also failed.
After that procedure, she was referred to Perez, who also is an associate professor of ophthalmology at the University of Miami, for what he calls a "procedure of last resort." He recently trained in Rome under Italian ophthalmologist Giancarlo Falcinelli, who had developed a modified version of the tooth-lens procedure invented by Italian doctor Benedeteo Strampelli.
Strampelli developed the procedure in 1963, but it didn't catch on for decades because of serious complications at one point, including the tooth-lens combination falling out of a patient's eye.
But with Falcinelli's modification, the procedure is spreading in Europe and Japan. In Ireland, a worker's sight was restored after his cornea was destroyed by red-hot liquid aluminum in an explosion at a recycling plant.
The procedure is called a modified osteo-odonto-keratoprosthesis. Outside experts agree the operation is a first in the United States, and they respect the procedure in the proper patients.
"It can be argued that this is suitable for the most severe of cases, in which the patient has completely dry eyes," said Dr. Claes Dohlman, cornea specialist at the Massachusetts Eye and Ear Infirmary, a teaching hospital of Harvard Medical School. "In those cases, (the procedure) has a reputation for long-term stability."
In the Miami operation, Thornton's eyetooth was chosen because it had a good amount of jawbone and ligament attached, which are crucial for it to stay alive and heal into the eye after being implanted, Perez said.
The eyeteeth - sometimes called canines - get their name because they sit in the mouth directly beneath the eyes.
After months of operations to meld the eye-tooth prosthesis, prepare the eye and then implant the new device, the bandages were removed over Labor Day weekend. Thornton could recognize faces within two hours.
Perez believes the patient's prognosis is good.
"If there isn't any infection, I'm optimistic we can preserve at least 20/70 vision for the next 10 years."