Anesthesia Considerations in Modified Osteo-odonto-keratoprosthesis

Area of Science:

• Ophthalmology
• Anesthesiology

Background:

• Modified osteo-odonto-keratoprosthesis (MOOKP) is a complex surgical procedure for severe corneal blindness.
• Patients undergoing MOOKP often have significant systemic comorbidities and airway challenges.

Purpose of the Study:

• To identify and analyze anesthesia-related challenges in patients undergoing MOOKP.
• To evaluate the safety and efficacy of anesthetic techniques in MOOKP procedures.

Main Methods:

• Retrospective cohort study analyzing medical records of 74 patients who underwent MOOKP between 2007 and 2015.
• Data collected included demographics, comorbidities, MOOKP indications, and anesthesia techniques across different surgical stages.
• Anesthetic assessments included American Society of Anesthesiologists (ASA) grading and Mallampati scores.

Main Results:

• The most common indications for MOOKP were Stevens-Johnson syndrome (53%) and chemical burns (38%).
• Most patients were ASA grade II (94.6%), with Mallampati scores generally indicating a good airway (score 1 in over 79%).
• Intubation difficulties were noted in a small percentage of patients (3 in stage 1A, 4 in 1B+1C, 1 in stage 2), with some requiring a second attempt or oral intubation.

Conclusions:

• MOOKP patients, despite generally good airway assessments, can present with intubation challenges.
• A thorough preoperative anesthetic evaluation is essential for each stage of MOOKP.
• Tailored intraoperative anesthesia management plans are critical for successful outcomes in MOOKP surgery.