The usefulness of echography before and after Osteo-Odonto-Kerato-Prosthesis

Abstract

The Osteo-Odonto-Kerato-Prosthesis (OOKP) is a particular biological pros­thesis whose implant is performed in two steps: in the first, the cornea is covered with mouth mucous and an acrylic cylinder, fixed on an osteo-odonto layer, is implanted in the eyelid. Three months later, the cornea, iris and lens are removed and the OOKP is implanted. The role of echography before OOKP is very important because it allows us to evaluate such aspects of the ocular conditions as: the different corneal layers, the anterior chamber with the depth and content alterations; the pupillar diameter and the condition of the iris, the irido-corneal, irido-lenticular synechias, the lens anomalies, and the vitreo­retinal conditions that could make OOKP surgery useless. Because of the acrylic cylinder, only the posterior pole can be visualized with ophthalmoscopy. Consequently, the echographic examination provides information on the conditions of the peripheral posterior segment.

Because these eyes are often affected by high intraocular pressure, which is not detectable by tonometry, echography should be used to evaluate the optic disk excavation and, after OOKP implantation, any previous antiglaucomatous surgery. Here, we report our experience with traditional equipment, new generation B-scan and with high frequency equipment (ultrasound biomicroso­py; UBM), which is particularly useful in the study of the anterior segment of these injured eyes.