How Tooth-in-eye Surgery Works

From Cheek to Cornea
You can see in this illustration that the canine teeth (shown in orange) have longer roots than other human teeth.
You can see in this illustration that the canine teeth (shown in orange) have longer roots than other human teeth.
© BSIP/UIG via Getty Images

The MOOKP procedure is an elaborate medical dance, one that requires the cooperation of not one but two corneal surgeons, an oculoplastic surgeon (a specialist in plastic surgery of the eye), a dentist and anesthetist. The operation actually occurs over two stages that take place months apart.

The first stage requires the extraction of a tooth. Surgeons typically choose one of the canine teeth because they have the longest roots. If you're one of many people terrified of dentistry and you're familiar with the literary concept of foreshadowing, take the phrase "because they have the longest roots" as your cue to begin shuddering in horror.

The surgeon knows she needs to take a good amount of the root tissue, as well as the periosteum, a fibrous layer made up of collagen and nerve fibers that covers all of your body's bones. So she cuts deep using a motorized saw to take out the tooth, leaving behind a rather gory gaping hole. This process is considered one of the most difficult aspects of the procedure because if the tooth fractures or too little tissue is taken, the whole operation will fail.

During the same operation, doctors also prepare the damaged eye, scraping away old scar tissue.

Once the surgeons have harvested the canine, the dentist carves the tooth into a smaller shape and drills a hole into the center. Then a plastic lens is inserted into the hole and dabbed with a bit of dental cement, creating what some specialists call a bio-integrated prosthetic unit.

The unit is implanted into the patient's cheek and left there, so the tooth periosteum and blood vessels grow around the tooth-lens combo, securing the lens to the tooth and providing the contraption with the circulation it will need to survive in the eye.

Two to four months later, surgeons retrieve the tooth from its cheek incubator. They then make a hole in the center of the cornea and insert the tooth and lens, grafting tissues around it to keep it in place. Each incision is sutured and the eye is re-inflated with filtered air. When successful, the operation means patients can immediately see the world around them.