It sounds crazy but it works: A tooth is extracted from a blind patient and a lens is glued inside, then the tooth is sewn into the eye — allowing the patient to see again.
It’s her friends’ faces. Blooming flowers. And her local golf course, where she fell in love with the sport.
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Those are the things Gail Lane misses seeing since she went blind a decade ago.
She has no idea what her partner of eight years looks like, as they met after she lost her sight.
“I’ve never seen Phil. And I have friends who are more newly acquired who I’ve never seen,” said Lane, 74.
Once an active volunteer, the retired provincial government worker now relies on a cane whenever she leaves her Victoria condo. “I am not independently mobile.”
But all that could change beginning on Tuesday.
Lane will become the first patient in Canada to undergo a rare and bizarre procedure that could restore her vision: One of her teeth will be extracted, a hole will be drilled into the tooth, a lens will be glued inside, and then the tooth will be sewn into her left eye.
She was incredulous when she first heard about the operation.
“What do you mean you use a tooth? It was kind of weird, just spooky in a way,” she laughed.
It sounds crazy, Providence Health ophthalmologist Dr. Greg Moloney admits, but he’s performed osteo-odonto-keratoprosthesis, also known as tooth-in-eye surgery, on seven patients in his home country of Australia.
Those patients, like Lane, had severe scarring on their eyes caused by some type of trauma, and most of them can now see again.
“It’s like replacing the windshield on a car when it’s totally frosted over,” said Moloney, who moved to Vancouver in 2021.
Lane had full sight until the age of 64, when she had a severe reaction to prescription drugs and developed Stevens-Johnson syndrome, a rare disorder of the skin that led to the scarring on her eyes.
On Tuesday, at Vancouver’s Mount Saint Joseph Hospital, oral surgeon Dr. Ben Kang will extract one of Lane’s canine teeth, which are also aptly known as eye teeth. It will be shaped, a hole will be drilled in the middle, and the plastic lens will be glued inside.
The tooth will then be sewn into Lane’s cheek, where it will stay for three months to allow a layer of tissue to form around it.
Also, a flap of skin will also be cut from inside Lane’s mouth, an area that the tooth is used to being near, and placed over the front of her eye.
“We lay it over the whole eyeball to try to let it take root. And then it turns into this pink, healthy, happy substance there,” Moloney said.
Part 1 of the surgery is expected to take about six hours.
Part 2 is scheduled for May.
The tooth will then be cut out of the cheek and Moloney will peel back the flap of skin placed over the eye in Part 1. He will remove the iris and lens, the damaged parts of Lane’s eye.
In their place he will insert the tooth. Moloney will use the tooth’s newly formed tissue to sew it to the eyeball.
Then the flap of skin will be laid back over the eye to help keep the tooth in place.
A small hole will be cut in that skin flap for Lane to see through.
“It looks like a little pink thing with a window in it,” Moloney said.
The plastic lens replaces the front part of her eye that no longer works: it will act like a telescope, allowing light to come in and hit the back of her eye, which still functions.
Part 2 also takes about six hours and, if all goes well, vision comes back within a month.
Most patients can resume many of the hobbies they did before losing their sight, although “heavy physical activities” should be avoided because the way they see will be different, Moloney said.
“They have a narrow visual field because they’re looking through a porthole.”
While this operation is new to Canada, it was first done in Italy more than five decades ago, when doctors searched for an object that would last a long time after having a lens glued into a hole and one that our bodies wouldn’t reject. They chose a tooth because it is the strongest bone in our bodies.
The surgery is now offered in a handful of countries, including England, Germany, Japan and India. South of the border, one operation was done in 2009 in Miami.
Most of the seven patients Moloney treated in Australia have functional eyesight today, he said.
After operating on Lane on Tuesday, Moloney is repeating the procedure on Wednesday and Thursday with two more patients from North Vancouver and Toronto.
And he recently received referrals of additional patients from Alberta, Manitoba and Ontario.
Moloney anticipates Canada will require only two or three of these surgeries a year in the future given the rareness of this kind of blindness, although he doesn’t know how many people there are like Lane who have been waiting years for this type of hope.
Moloney, the tooth fairy of eye surgeons, had hoped to begin these operations in Canada shortly after arriving in 2021. But it took a tremendous amount of organization, training and money to get everything ready to go, one of the reasons why a relatively small number of countries offer the procedure, he said.
St. Paul’s Hospital Foundation raised $430,000 to fund the first three years of this work, and after that Providence will absorb the costs into its budget, a spokeswoman said.
“The resources that we invest into this small group of people are a lot, but the effect on those people is really dramatic. It’s life-changing,” Moloney said.
He recalled one Australian patient after the surgery sitting in her hospital bed on a video call with her extended family, as her mother reintroduced her to everyone.
“‘This is cousin Bob, and this is Uncle Jim.’ She’d heard their voices for 30 years and never knew what they looked like,” he said, his eyes misty from the memory.
“It’s very emotional. I get quite emotional about this.”
And, Moloney said, there is a net saving for society as many of his patients were reliant on disability payments before their surgeries but now live independently.
Lane is feeling grateful, excited and scared about her historic operation on Tuesday. She said she has confidence in Moloney’s team and feels she has nothing to lose if the surgery isn’t successful.
But she has so much to gain if it is.
She can’t wait to see what her longtime friends look like today.
“They’re all frozen in time for me,” Lane said.
“And I haven’t seen myself for 10 years,” she added with a nervous chuckle.
“If I’m fortune enough to get some sight back, there will be wonderful things to see.
“It’s like a miracle.”
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