Surgeons Are Conducting Rare ‘Tooth-in-Eye’ Surgeries to Restore Vision to Blind Patients in Canada

Gail Lane lost her eyesight ten years ago, the result of a bad reaction to prescription drugs. For the last decade, the 74-year-old retiree in Victoria, Canada, has not seen her friends’ faces, nor has she looked at herself in the mirror. She has no idea what her partner looks like, because they met after Lane went blind.

But, soon, she may be able to see again, reports the Vancouver Sun’s Lori Culbert. Lane is one of a handful of patients in Canada who are undergoing a rare surgery in hopes of restoring their vision. Called “tooth-in-eye” surgery, the procedure is what it sounds like: It involves surgically embedding a patient’s tooth into their eye.

Known more formally as osteo-odonto keratoprosthesis (OOKP), the surgery has been performed successfully in a handful of countries over the last five decades, but never before in Canada.

In late February, three patients in Canada—including Lane—underwent the first part of the complex procedure. If all goes according to plan, they might have their eyesight back by summer.

Their operations were led by Greg Moloney, an ophthalmologist at Mount Saint Joseph Hospital in Vancouver, British Columbia. After performing the procedure on seven patients in Australia, his home country, Moloney is now bringing the surgery to Canada by opening the country’s first OOKP clinic.

The nonprofit St. Paul’s Hospital Foundation raised $430,000 to fund the clinic for its first three years. After that, Providence Health Care, a British Columbia health care provider, will supply the funding.

“The resources that we invest into this small group of people are a lot, but the effect on those people is really dramatic,” Moloney tells the Vancouver Sun. “It’s life-changing.”

Developed in Italy in the 1960s, tooth-in-eye surgery is a multi-step process that starts with extracting one of a patient’s canine teeth. Surgeons then shape the tooth into a rectangle, drill a hole into it and glue a plastic optical lens inside the hole. They then surgically embed the tooth into the patient’s cheek so that a layer of tissue can grow around it. During the same procedure, they also cut a flap of skin from inside the patient’s cheek and surgically attach the skin to the front of the patient’s eyeball.

Then, they wait. Three months later, if all goes to plan, they embark on the second phase of the operation. They pull back the flap of skin from the eye, then remove any previously damaged tissue, like the lens and the iris. Next, they remove the tooth from the patient’s cheek and surgically embed it into the eyeball. They then lay the flap of skin back over the eyeball and cut a small hole for the patient to see out of.

“It won’t look like a normal eye,” Moloney tells CTV News’ Shannon Paterson. “The eye will look pink with a small dark circle in the middle.”

The patient’s vision usually comes back within a month of the second phase of the surgery. For these three individuals in Canada, that part of the procedure is scheduled for May. Afterward, patients can’t see perfectly—they have a narrower field of vision, similar to peering through a porthole—but they can usually resume some of the activities they had to stop when they went blind. One woman in Australia started skiing again, reports CBC Radio’s Sheena Goodyear.

Surgeons use teeth because of their strength and durability. Teeth are made of dentin, which is one of the hardest substances in the body. And, since they are part of the patient’s own body to begin with, teeth are not typically rejected after the surgery.

“We are trying to really just replace a clear window on the front of the eye,” Moloney tells CTV News. “The tooth is the perfect structure to hold a focusing piece of plastic or a telescope for the patient to see through.”

Historically, patient outcomes have been positive. In a 2022 study, researchers followed 59 patients who had the surgery on 82 eyes between 1969 and 2011. Nearly all the teeth—94 percent—were still in place at the end of the follow-up period, which was almost 30 years later, on average.

In addition to Canada, tooth-in-eye surgery is performed in several other countries, including India, Japan, the United Kingdom and Germany. In 2009, surgeons performed the procedure on a patient in Miami.

But tooth-in-eye surgery is not a fix-all. It’s primarily used as a last resort, when other types of treatment fail. And it only works for some patients. Typically, it’s best for those who have suffered scarring or severe tissue damage to their cornea—the front layer of the eyeball—but still have a healthy retina and optic nerve at the back of their eye.

Brent Chapman, one of the Canadian patients who recently underwent the surgery, lost his vision when he was a teenager. His body had a rare auto-immune reaction to ibuprofen called Stevens-Johnson syndrome. The reaction caused severe burns all over his body—including in both of his eyes—and Chapman was in a coma for nearly a month.

Since then, he’s undergone dozens of surgeries, some of which have partially restored his vision—but only temporarily. Now 33 years old, Chapman hopes the tooth-in-eye procedure will finally, permanently restore his vision, so he can do things like play basketball and travel.

He knows the surgery sounds “a little crazy and science fiction-y,” Chapman tells CBC Radio. But he’s optimistic it will work.

“The risk-reward ratio for these patients, when they have no vision at all, is well worth it, we think,” Moloney tells CBC Radio.

Lane also initially found the idea of the surgery to be “kind of weird, just spooky in a way,” she tells the Vancouver Sun. But she, too, is hopeful the procedure will restore her vision so she can resume golfing again.

“If I’m fortunate enough to get some sight back, there will be wonderful things to see,” she tells the Vancouver Sun. “It’s like a miracle.”

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Sarah Kuta is a writer and editor based in Longmont, Colorado. She covers history, science, travel, food and beverage, sustainability, economics and other topics.