A Tooth Implanted in the Eye Was Still Holding Sight 45 Years Later, and Canada’s First Patients Can Now See Faces

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Yet a review spanning five decades shows that, for many patients with otherwise untreatable corneal blindness, the tooth-built lens keeps working for 20 years or longer.

The study, published in the November 2025 issue of the British Journal of Ophthalmology, is the longest-running look at osteo-odonto-keratoprosthesis, or OOKP. It arrives as Canada’s first three patients to receive the operation report seeing faces, pets and city skylines again.

Italian researchers reviewed 310 eyes in 269 patients who underwent a modified version of the surgery at two Rome hospitals between 1973 and 2019. The average follow-up was nearly 16 years, and the longest stretched to 45 years.

The most common reasons for surgery were chemical or physical injuries to the eye, in 35.2% of cases, followed by ocular pemphigoid, an autoimmune disease that scars the eye’s surface, in 24.2%.

When the eye was covered with tissue from the inside of the cheek, as in almost 90% of cases, 85.1% of implants remained in place at 20 years and 82.3% at 45 years. Functional survival, meaning the eye still provided useful sight, was 70.7% at 20 years and 56.5% at 45 years. Eyes covered with skin instead fared significantly worse. Vision improved sharply within three months and held steady in about two-thirds of patients.

The authors concluded that the procedure showed “excellent long-term anatomical and functional survival rates.” The estimates at the longest time points rest on small numbers, about 10 eyes at 45 years, and the study was retrospective, with surgical technique evolving across the decades. A separate 2022 review of 958 patients across 37 published case series reported a similar anatomical success rate of about 88%.

The operation was introduced by Italian surgeon Benedetto Strampelli in the 1960s and later refined by Giancarlo Falcinelli, who performed many of the surgeries in the review and who died in 2017.

In the first stage, a surgeon removes a tooth, usually a canine, along with a slice of surrounding bone. The piece is shaped and drilled, and a plastic optical cylinder is glued in. The assembly is implanted under the skin of the cheek for roughly three months so tissue can grow around it, while a flap of cheek lining is sewn over the damaged eye.

In the second stage, surgeons uncover the eye, remove the damaged iris and lens, and stitch the tooth-lens into place, leaving a small opening in the tissue for the patient to see through.

“A tooth contains dentin, which is the ideal tissue to house a plastic lens without the body rejecting it,” Vancouver ophthalmologist Dr. Greg Moloney said in a Providence Health Care announcement.

Moloney, who learned the procedure in his native Australia and was recruited to Vancouver in 2021, led Canada’s first three cases at Mount Saint Joseph Hospital in 2025. He had performed about eight of the operations in Australia.

Gail Lane, a 75-year-old Victoria resident who lost her sight at 64 after anti-seizure medication triggered Stevens-Johnson syndrome, had her first-stage surgery in February and her second in late May. Her vision returned gradually, starting with light and large shapes. By mid-July, she could see her partner’s guide dog. “I could see Piper’s tail wagging,” she said, according to Providence Health Care. With glasses, her vision measured 20/50.

Brent Chapman, 34, of North Vancouver, had a severe reaction to ibuprofen as a teenager that left him in a coma and cost him most of his sight. He told CNN he had undergone close to 50 operations over 20 years, most of them corneal transplants that never lasted. His tooth was removed in February, the structure placed in his eye in June, and a final procedure in August straightened the lens. Fitted with glasses days later, he reached 20/30. “I haven’t really made eye contact in 20 years,” he said. A third patient, who declined interviews, could read documents the day after surgery.

Dr. Vicente Diaz, an ophthalmologist at Yale School of Medicine who was not involved in the cases, told CNN the procedure is for situations where “a standard corneal transplant simply won’t work.”

The surgery carries real risks. In the Italian review, glaucoma occurred in 22.6% of eyes, endophthalmitis, a serious infection inside the eye, in 7.7%, and retinal detachment in 6.4%. Endophthalmitis was the most dangerous complication, usually requiring removal of the implant. The tooth and bone can also slowly resorb, which the authors documented in at least 14% of eyes, and the eye does not look natural afterward.

Candidates must have a working retina and optic nerve, and the Rome team excluded patients younger than 17, among other criteria. The procedure cannot help people whose blindness originates behind the cornea.

Availability in North America remains extremely limited. Moloney has said the first goal was completing the surgeries without complications, and that the next is confirming the implants stay viable long term. The Rome data suggest that, for well-selected patients, many of them do.

People with severe corneal scarring who have been told transplants will not work should ask a cornea specialist whether they might be evaluated for a keratoprosthesis.

Osteo-odonto-keratoprosthesis uses a patient’s own tooth and surrounding bone as a living frame to hold a plastic lens that replaces a badly scarred cornea.

Adults with blindness from severe eye-surface damage, such as Stevens-Johnson syndrome, chemical burns or ocular pemphigoid, who still have a healthy retina and optic nerve.

In the Rome review, 85.1% of implants covered with cheek lining remained in place at 20 years, and 56.5% of eyes still had useful vision at 45 years.

Glaucoma, serious eye infection, retinal detachment, and gradual loss of the tooth-bone support. Lifelong follow-up with an eye specialist is required.

Is the surgery available in North America?

It is very rare. Vancouver’s program at Mount Saint Joseph Hospital is one of the few active efforts on the continent.