OP-9 Surgical management of late complications in osteo-odonto-keratoprosthesis (OOKP). The role and challenges of the multidisciplinary team at moorfields eye hospital

Purpose To present our experience in the surgical management of late complications in Osteo-Odonto-Keratoprosthesis (OOKP) following transfer of this highly specialised Service to Moorfields Eye Hospital. Method During the first year following transfer of the OOKP Service, five surgical interventions in four patients were performed by a multidisciplinary team treating unique complications. A total of three retinal detachments repairing procedures were performed by endoscopic vitreo-retinal approach. One patient presented severe chronic cystoid macular oedema and required fornix and buccal mucosa dissection to allow periocular injection of triamcinolone. One patient affected by LOGIC syndrome presented with aqueous leak, hypotony and significant vision deterioration in his only OOKP eye and underwent urgent osteo-dental lamina repair. Results In one patient endoscopic surgical repair was not successful in restoring vision because of advanced tractional retinal detachment following endophthalmitis managed elsewhere. Another patient with retinal detachment regained sight in his only eye but required repeat endoscopic VR surgery. One patient with cystoid macular oedema improved his vision in his only eye following periocular injection of triamcinolone. One patient with LOGIC syndrome underwent surgical re-suturing and repairing of his thin osteo-dental lamina which resolved the aqueous leak and this patient recover his previous 6/6 vision. Conclusions The OOKP is a highly specialised service and these unique complications require a multidisciplinary team. Moorfields Eye Hospital is now the National Referral Centre for OOKP and the multidisciplinary team is committed to introduce innovations aiming to improve the surgical techniques.