Tamil Nadu   

Hope restored for the corneally blind

"A successful MOOKP procedure is almost like a rebirth for the patient"

It may have been his mentor, who discovered a rare meeting point between dentistry and sight-restoring ophthalmology over four decades ago. But, Italian ophthalmologist Gian Carlo Falcinelli is credited with perfecting his teacher Benedetto Strampelli's near-abandoned implant procedure that involves using a human canine tooth in restoring vision to the corneally blind.

In between a busy schedule, training young ophthalmologists and reviewing patients at Sankara Nethralaya, the Italian doctor speaks through an interpreter about the technique's potential in developing countries during a conversation with R. Sujatha and M. Dinesh Varma.

Dr. Falcinellis' Modified Osteo Odonto Kerato Prosthesis (MOOKP) technique has helped hundreds of patients in several countries see the world again in all its colours and light.

The Italian doctor has performed over 275 procedures on patients blinded either by trauma, chemical exposure or Stevens Johnson Syndrome (a form of severe drug reaction). In such cases, conventional interventions such as stem cell transplants seldom work, as the injured eye is dry.

Dr. Falcinelli, currently working for San Camillo Hospital in Rome, has been imparting training in the procedure to ophthalmologists in India, which houses one-third of the estimated 11 million corneally blind population in the world.

Under his guidance, Sankara Nethralaya is establishing an exclusive centre for MOOKP procedures to be headed by G. Sithalakshmi.

The MOOKP procedure is done in two stages: In the first stage the patient's canine tooth is removed and prepared to hold the cylinder (lens). The tooth is then placed in a pocket under the skin of the other eye.

A three-centimetre mucous membrane is removed from inside the cheek to cover the sclera of the injured eye.

In the next stage, about four-five months later, the tooth, which is by now surrounded by soft tissue, is removed and placed behind the mucous membrane graft in such a way that only the cylinder protrudes out of the eye thus enabling the patient to see and reducing the chances of extrusion of the prosthesis from the eye. Regular follow up is vital to prevent risks of complications.

According to Dr. Falcinelli, the MOOKP works just as well across age groups as it has now been established that in cases where it is not possible to extract a tooth from the patient such as in very young or elderly people, those of a related donor can be used along with immuno-suppresants.

Among his earlier patients, some had not seen the world for 30-40 years, today lead normal lives.

"MOOKP represents hope for the hopeless. A successful implant is almost like a rebirth for the patient," he says.

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