A new way to treat Blindness.
At about the same time that President Barrack Obama decided to honour the ‘Father of Lasik eye surgery’ – – – the 83 year old Dr. Rangaswamy Srinivisan with the U.S.’s highest scientific award – – – the National Medal for Technology and Innovation, and instal him as the only scientist of Indian origin celebrated in the U.S. National ‘Invention Hall of Fame’, alongside such legends as Thomas Alva Edison, Henry Ford, Samuel Morse, the Wright Brothers, and others, – – – a son of Belgaum’s soil, having returned from the U.S. with advanced degrees in Ophthalmology performed a path-breaking operation here in Belgaum, to gift sight to Gururaj, 34, of Bailhongal, by using Gururaj’s tooth to form the vital part of Gururaj’s eye.
For Gururaj, who was blind in the right eye for the past 10 years, to actually see light through that eye, and then to slowly discern shapes and even to read a calendar which was 4 feet away – – – was nothing short of a miracle !!
In an operation that has never before be performed in the Western part of Peninsular India . . . neither in Mumbai, nor in Bangalore, Dr. Siddharth Pujari, 38, put to test the skills he picked up from Dr.Falcinelli, Rome, Italy and Dr.Foster, Harvard University, USA , to pioneer this technique in this part of India.
The actual operation itself, performed by Dr. Siddharth Pujari on 14th December 2012, took 7 hours, but the procedure was begun some 7 months earlier in June 2012, when, Dr. Siddharth Pujari along with Dr.Neelkamal Hallur (Maxillofacial surgeon, Hubli) extracted Gururaj’s canine tooth and fixed a optical cylinder which was ‘naturalised’ over the next few months by putting under his eyelid skin. This cylinder-tooth complex was stitched into a part of Gururaj’s cornea and light entered Gururaj’s eye for the first time on 17th December 2012, at 10:15 am.
For Gururaj, it was a miracle.
But for the rest of us it is science fiction come true.
“A tooth for a tooth, and an eye for an eye” was supposed to be the law of pre-civilized societies. However, “A tooth for an eye . . . ?” might well end up as the hall mark of all civilized societies which tend to treat blindness as curable.
The technique that Dr. Siddharth Pujari used to restore sight to Gururaj’s right eye is not entirely new. What is important is that it has never before been used in this part of Western India where the prevalence of ocular inflammatory diseases is well known.
The technique, known as Modified Osteo-Odonto-Kerato-prosthesis, or MOOKP for short, holds hope for all those whose cornea is scarred from ocular inflammatory diseases and chemical burns to a point of corneal blindness and in patients with severe dry eyes in whom corneal transplants from eye donors is not a viable option.
The M.O.O.K.P. procedure is done in two stages. In the first stage the patient’s canine tooth is removed and prepared to hold the optical cylinder (lens).
The tooth is then placed in a pocket under the skin of the other eye. A three-centimeter 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.
Since the tooth’s dentin is the strongest tissue of the body and is a part of the patient’s body there is no rejection of it by the body and, hence, medication is minimal and time bound.
Regular follow up is vital to prevent risks of complications.
Dr. Siddharth Pujari was assisted by Dr. Neelkamal Hallur, a maxillofacial surgeon from Hubli and supported by MMJEI, Bharatesh Hospital and Vasan Eye Clinic Belgaum.
He was trained for this technique by the pioneer of osteo-odontokeratoprosthesis Dr.Falcinelli, San Camillo Hospital,Rome,Italy. He also acknowledges the debt he owes to his Professors at the various educational institutions that he studied at.
The procedure was complicated and involved three stages:
Stage 1: Removal of lens and iris and vitrectomy.
Stage 2: Removal of the tooth, fixing the optical cylinder followed by
naturalization by putting it under the eyelid skin and grafting the mucous
Stage 3: Implanting the tooth in the cornea and creating an opening in the mucous
membrane for the optical cylinder.
The procedure was complicated but rewarding to the patient. Today he is able to see a distance of 4 feet and elated that he can see the world after a long gap of 10 years.