Clinical study of laminar resorption: Part 1 - Factors affecting laminar resorption

Purpose: To analyse the factors affecting laminar resorption in the UK osteo-odonto-keratoprosthesis (OOKP) cohort and present a detailed review.

Methods: A retrospective review of the case records of the patients who underwent OOKP between 1996 and 2014 was performed at the Sussex Eye Hospital in Brighton, UK.

Results: Sixty-four patients (25 females and 39 males) were included, and 74 laminae were implanted consisting of 3 tibial grafts, 11 tooth allografts and 60 tooth autografts. In total, 69% (n = 51) showed resorption. Non-smokers had better oral health compared to smokers (71% vs 50%, respectively). Poor oral health was strongly associated with poor quality dentition and edentulism (p < 0.001). The laminar thickness and waiting for the time between stages 1 and 2 surgeries did not show significant influence on the onset and progression of resorption. From the Cox multivariate analysis for autografts, smoking, age and gender were not associated with a statistically significant difference in the rates of resorption. The maximum number of laminae with resorption belonged to Stevens-Johnson syndrome patients (n = 32 or 43%).

Conclusions: Two-thirds of the cases of resorption were detected in the first three years of OOKP, and the maximum were noted in the first year of follow up (40%). The laminar thickness did not influence the post-operative onset and progression of resorption. The presence of resorption after stage 1 did not show a measurable effect on the onset and progression of post-stage 2 resorption.