Synthetic osteo-odonto-keratoprosthesis (OOKP, Tooth-in-Eye surgery)

项目摘要： 骨齿人工角膜（OOKP）或眼内拔牙手术是一种特殊的手术，可以节省 严重受伤的角膜OOKP手术是有效的，能够治疗多次角膜移植后的角膜。 移植失败，或者当角膜被Stevens-Johnson综合征，类天疱疮， 化学烧伤沙眼和多处角膜移植失败 OOKP的成功率很高，但是，它是一个积极的过程，耗时，涉及部分 牺牲病人的口腔。该提案旨在通过制备一种新型的OOKP合成物来简化这种手术。 假肢 在OOKP手术的第一阶段，患者的牙齿和周围组织被收获以制作一个 称为骨齿板的自体移植假体，其中放置光学圆柱体。 然后将该结构植入肌下袋中2-4个月以实现血管化。在第二 在手术阶段，将带血管的骨齿板插入眼内，作为固定支架 PMMA光学圆柱体。 在这个建议中，我们为OOKP手术建立了一个特殊的人工角膜，作为骨牙的替代品， 因此外科医生不需要采集患者的牙齿和周围的颌骨。 为此，我们将遵循我们在最近发布的专利中提出的总体设计。虽然 在我们的专利中已经提出了人工角膜的设计和想法，但还没有生产， 而有关的结构细节尚待在本建议书中作出规定。更具体地说，我们要计算出 以模拟假体不同部分的材料、密度、孔隙率和孔径的方式， 自然骨齿板结构的细节，特别是模仿它的特点，是负责 成功的关键我们将使用钛合金和3D打印技术来制造这个 人工角膜 通过考虑我们模拟这种构建体的标准，我们将制作18个样品。他们将经历一个完整的 物理、机械和体外表征，以找到最优化的人造OOKP人工角膜。 总之，OOKP手术是一种多学科、劳动密集型和侵入性的手术，需要牙科和 眼科专业知识。通过使用我们的新假体，OOKP手术可以消除一个非常 手术的侵入性阶段，对患者造成伤害，并可能使治疗的总时间缩短一些 个月这将大大提高严重角膜损伤患者的治疗效果。

Project Summary: Osteo-odonto-keratoprosthesis (OOKP) or Tooth-in-Eye surgery is an exceptional procedure that can save severely injured corneas. The OOKP procedure is effective and capable of treating corneas after multiple corneal transplantation failures, or when the cornea is severely damaged by Stevens–Johnson syndrome, pemphigoid, chemical burns, trachoma and multiple corneal graft failure. The success rate in OOKP is high, however, it is an aggressive procedure, time consuming and involves partial sacrifice of the patient's oral cavity. This proposal aims to simplify this surgery by making a novel OOKP synthetic prosthesis. At the first stage of the OOKP surgery, a patient's tooth and surrounding tissue are harvested to make an autograft prosthesis called an osteo-odonto-lamina into which an optical cylinder is placed. This construct is then implanted into a submuscular pouch for 2–4 months to be vascularized. At the second stage of the surgery, the vascularized osteo-odonto-lamina is inserted into the eye to act as a frame for holding a PMMA optical cylinder. In this proposal, we build a special keratoprosthesis for the OOKP surgery as a replacement of the osteo-odonto- lamina so the surgeons do not need to harvest teeth and surrounding jawbone of the patients. For this purpose, we will follow the general design we have proposed in our recently issued patent. Although the design and idea of the keratoprosthesis have already been proposed in our patent, it has not been produced, and the details of the construct are yet to be configured in this proposal. More specifically, we are going to figure out the material, density, porosity, and pore-size of the different parts of the prosthesis in a way to mimic the details of the natural osteo-odonto-lamina structure, and particularly mimic the features of it that are accountable for the success of OOKP surgery. We will use a titanium alloy and 3D-printing technique to fabricate this keratoprosthesis. By considering our criteria for mimicking such construct, we will make 18 samples. They will go through a full physical, mechanical, and in vitro characterizations to find the most optimized synthetic OOKP keratoprosthesis. In sum, OOKP surgery is a multi-disciplinary, labor-intensive, and invasive procedure requiring both dental and ophthalmology expertise. Through the use of our new prothesis, the OOKP procedure can eliminate one very aggressive stage of the surgery that harms patients and can reduce the overall length of the treatment by a few months. It will considerably enhance the treatment of patients with severely injured corneas.