Bone augmentation of the osteo-odonto alveolar lamina in MOOKP—will it delay laminar resorption?

Geetha Iyer, Bhaskar Srinivasan, Shweta Agarwal, Ekta Rishi, Pukhraj Rishi, Gunaseelan Rajan, Shanmugasundaram Shanmugasundaram

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Purpose: We aimed to describe a new technique and analyse the early outcomes of augmenting the canine tooth using a mandibular bone graft in an attempt to delay or retard the process of laminar resorption following the modified osteo odonto keratoprosthesis (MOOKP) procedure. Design: This was a retrospective case series. Patients and methods: Eyes that underwent the bone augmentation procedure between December 2012 and February 2014 were retrospectively analysed. The procedure, performed by the oromaxillofacial surgeon, involved securing a mandibular bone graft beneath the periosteum on the labial aspect of the canine tooth chosen to be harvested for the MOOKP procedure. This procedure was performed simultaneously with the Stage 1 A of the MOOKP. Three months later, the tooth was harvested and fashioned into the osteo-odonto alveolar lamina similar to the method described in the Rome–Vienna Protocol. Results: The bone augmentation procedure was performed in 11 eyes (five SJS/ six chemical injuries). The mean follow-up after Stage 2 of MOOKP procedure in these eyes was 7.45 months (2 to 20 months). Complications noted were peripheral laminar exposure (three eyes—SJS) and bone graft exposure and necrosis in the mouth (nine—SJS). No evidence of clinical laminar resorption was noted in any of the eyes. Conclusion: Laminar resorption in MOOKP can lead to vision and globe threatening complications due to the consequent cylinder instability and chances of extrusion. Augmenting the bone on the labial aspect of the canine tooth might have a role to play in delaying or preventing laminar resorption.

Original languageEnglish (US)
Pages (from-to)1137-1141
Number of pages5
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Issue number7
StatePublished - Jul 29 2015
Externally publishedYes


  • Bone grafting
  • Keratoprosthesis
  • Modified osteo odonto keratoprosthesis
  • Ocular chemical injuries
  • Stevens Johnson syndrome

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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