Anesthesia Considerations in Modified Osteo-odonto-keratoprosthesis.

PURPOSE: The purpose of this study was to elucidate anesthesia-related challenges in 74 cases who underwent modified osteo-odonto-keratoprosthesis (MOOKP).

DESIGN: Retrospective cohort study.

METHODS: Medical records of 74 consecutive patients who underwent MOOKP surgery between January 2007 and January 2015 were studied. Data such as demographic details, systemic comorbidities, indications for MOOKP, anesthesia techniques, and postoperative events in various stages of MOOKP were collected and analyzed.

RESULTS: The mean age of the patients was 29.7 ± 9.13 years. Of the 74 patients, 47 were men. The most common indication for MOOKP was found to be Stevens-Johnson syndrome (53%) followed by chemical injury (38%). In all stages of the MOOKP procedure, 94.6% of cases were found to have American Society of Anesthesiologists (ASA) score grade II, whereas 4.6% had grade III. Mallampati score of 1 was found in 79.7% of cases in stage 1, 82.4% of cases in stage 1B + 1C, and 81% of cases in stage 2. Recovery grade of 10 was noted in all the cases at all stages of the MOOKP procedure. Intubation in the second attempt was carried out in 8 cases and oral intubation in stage 1B + 1C was performed in 4 cases. Difficulty in intubation was noted in 3 cases in stage 1A, 4 cases in stage 1B + 1C, and 1 case in stage 2.

CONCLUSIONS: In patients undergoing MOOKP, a good preanesthetic evaluation and intraoperative anesthesia plan before each stage could help in successful administration of anesthesia in these patients.