Long-Term Follow-Up Results For Temporo-Parietal Flap Incorporated Into A Modified Osteo-Odontokeratoprosthesis.
Published 2024 - 42nd Congress of the ESCRS
Reference: FP31.03 | Type: Free paper | DOI: 10.82333/bemj-ds51
Authors: June Artaechevarria Artieda* 1 , Tanya Trinh 1 , Gregory Moloney 2 , Luke Northey 1 , Shannon Webber 3 , Georges Hazan 4
1Cornea and Anterior Segment,Sydney Eye Hospital,Sydney,Australia, 2Cornea and Anterior Segment,Pacific Eye Laser Centre,Vancouver,Canada, 3Maxillofacial and Implant Surgery,Gold Coast Oral,Benowa,Australia, 4Radiology,Sydney Eye Hospital,Sydney,Australia
Purpose
To describe the long-term results of the pedicled temporo-parietal flap to delay laminar resorption in a modified osteo-odonto keratoprosthesis (MOOKP) and measure resorption of the dental lamina by an objective method.
Setting
Quaternary referral hospital.
Methods
A retrospective case series was performed on patients who received an osteo-odontokeratoprosthesis for Steven-Johnson-Syndrome. Surgeries were performed between October 2016 and November 2017 by the same surgical team (G.M. and S.W.). A modified temporo-parietal flap was incorporated into stage 1 of the MOOKP procedure. Brain and orbit CT scans were performed post op and yearly on follow up. Volumetric evaluation was achieved by automated software analysis of 3D reconstructed CT images (Vitrea, Software Version 6.7.6, Cannon Medical Systems ANZ Pty Ltd).
Results
The procedure was performed in 3 eyes from 3 patients. Mean follow up time was 6 years (range 53-85 months). Volume measurements in the dental lamina for patient 1 were 1.84 cm2 post op, 1.77 cm2 at 1 year, 1.62 cm2 at 3 years, 1.56 cm2 at 6 years. For patient 2, dental lamina volume values were 1.85 cm2 post op, 1.77 cm2 at 1 year, 1.59 cm2 at 4 years, 1.82 cm2 at 5 years and 1.61 cm2 at 6 years. In patient 3, post op volume was 1.1 cm2, showing only subtle changes during her 4,5 years follow up.
Conclusions
The incorporation of a temporo-parietal flap is a safe and effective procedure that can decelerate the loss of volume of dental lamina, prolonging the survival of the MOOKP. The usage of an objective CT-based calculation of laminar volume may reduce inter-study variability and standardize comparison of techniques.