Man regains vision after rare surgery

Brent Chapman, now 34, had a severe reaction to ibuprofen at the age of 13, causing burns all over his body, including the surface of his eyes. He lost his left eye to an infection and most of his vision in the other. For 20 years, he underwent close to 50 surgeries, mostly cornea transplants, to try and save his right eye.

According to the report, Dr. Greg Moloney, a clinical associate professor of corneal surgery, performed a rare procedure called tooth-in-eye or osteo-odonto-keratoprosthesis, which involved implanting Chapman’s own tooth into his eye to restore his sight.

Chapman said he’s “very happy and just taking in the world again, appreciating the little things” after the surgery. The procedure involves removing a patient’s tooth, sewing a piece of it into the cheek, and placing the structure into their eye.

Dr. Vicente Diaz, an assistant professor of ophthalmology and visual science, explained that the condition, Stevens-Johnson syndrome, causes severe inflammation of the skin and mucous membranes, including the eyes. In some cases, the immune system attacks and destroys the limbal stem cells, essential for keeping the cornea clear.

The cornea acts like a windshield, allowing light to pass through to the lens and then to the retina, where it is converted into electrical signals sent to the brain. In conditions like Stevens-Johnson syndrome, those systems fail, and the cornea becomes permanently opaque.

When the cornea is permanently opaque and the eye rejects a cornea transplant, surgeons sometimes turn to tooth-in-eye surgery. A canine tooth is extracted from the jaw, along with a thin layer of bone, and shaved into a 4 millimeter-thick block to hold a plastic optical cylinder.

The tooth is implanted into the patient’s cheek or eyelid for several months, allowing soft tissue to grow around it. The tooth-lens complex is then surgically attached to the front of the eye, replacing the damaged cornea’s function.

Moloney said there are two types of candidates for the surgery: people like Chapman, who have tried every other procedure, or those who are severely affected by their initial disease. The surgery can take over 12 hours across two stages and is performed by only a handful of specialists worldwide.

Chapman’s tooth was extracted in February, and the structure was placed into his eye in June. His last surgery, which straightened the lens to correct visual distortion, took place August 5. He was fitted with glasses on August 13 and now has 20/30 vision.

Chapman said the first thing he saw after his surgery was the skyline from Moloney’s 16th-floor office. “It’s really indescribable, to be able to see the whole city and how there’s a whole world that’s just intersecting,” he said.

Before the tooth-in-eye surgery, Chapman was close to giving up hope. “We definitely didn’t have any more options,” he said. “The transplants were lasting such a short time, and they were becoming more risky to do surgically.”

Chapman is looking forward to traveling, with Japan being on the top of his list. He’s also excited to work again as a massage therapist and spend time with his niece and nephew, who are 4 and 2 years old.

Moloney said having “human connection again visually” is something that people take for granted but is very powerful for people with poor vision. “We’ve all waited a long time” for Chapman to regain his sight, he said.

More information on Stevens-Johnson syndrome can be found on the Wikipedia page for the condition.