A missing tooth isn’t stopping Brent Chapman from smiling.
The North Vancouver man's canine has been surgically implanted in his right eye, giving him a lasting lease on vision for the first time in 20 years.
After a full day in the operating room on June 6, Chapman became one of the first three candidates in Canada to receive a procedure called osteo-odonto-keratoprothesis, better known as tooth-in-eye surgery.
It involves extracting a patient’s tooth, putting a plastic lens in it, then fixing that to the patient’s eye socket. The tooth is held in place with flesh from the patient’s cheek.
This bit of macabre medicine might sound extreme – and it is.
When his dad first brought it up to Chapman as a young teenager, he wouldn’t even consider it.
“I was very young, and I just wanted to be normal and fit in. And he showed me this, and I was like, ‘Dad, we’re not doing that. What are you talking about? Putting a tooth in my eye. This is science fiction,’” said Chapman, who is now 33 years old.
Even his surgeons warned him off it at the time.
“They would be like, ‘Don’t do it. It’s extremely hard surgery. It’s long. You can’t get it in Canada. You’re very young,’” Chapman said. “They wanted to explore all the options.”
But dozens of procedures later – all of which led to only short-term success – tooth-in-eye became his best and maybe only option see again.
Lost sight due to allergic reaction to ibuprofen
Chapman’s decades-long journey to restore his sight began when he lost it.
He was playing at a Christmas basketball tournament when he was 13. Through the physical activity, Chapman was feeling sore. So he took some ibuprofen.
What he didn’t know was that he had a rare condition called Stevens-Johnson syndrome. Instead of relieving his discomfort, the over-the-counter drug caused a catastrophic allergic reaction in over 90 per cent of his body. The burn-like wounds affect mucosal membranes in particular, which included Chapman’s nostrils, lungs and eyes.
With Chapman’s life on the line, he was placed under medically induced coma for 27 days. He describes that experience as living in a psychedelic dreamworld, which was at times “beautiful” and others “terrible and a nightmare.”
When he awoke, Chapman began a gruelling rehab process. He had to relearn how to eat and walk. Slowly, most aspects of his physical health recovered – except for his eyesight.
Due to a bad infection, he lost his left eye completely. And the cornea (outer layer) of his right eye was damaged so badly that he couldn’t see out of it anymore. Also destroyed was Chapman’s ability to produce tears, which are necessary for an eye’s health and function.
That started a long and emotionally draining search for a solution. Supported by his parents and the provincial health care system, Chapman travelled around the world – to countries like the U.S., Italy and Singapore – trying different medical procedures to restore his cornea.
On a few occasions, stem cells were taken from his parents’ eyes in hopes the material could help fix the trauma in Chapman’s eye. Some of the operations worked, allowing him to see the world again for a time, but none lasted more than a year.
And each procedure increased the risk that his eye could be compromised beyond repair.
Conversation with successful patient changed mind about 'science fiction' surgery
Around two years ago, what Chapman once considered science fiction started to become science reality.
An Australian doctor that he happened to meet around the beginning of his battle with blindness had returned to Canada – Vancouver, in fact – to open a practice that would focus on tooth-in-eye.
Chapman still had some doubts, but the last of them were settled by a phone call with a former success story in Australia – a woman named Heather, who’s in her 60s and skiing down mountains again.
“I was kind of pressing her to tell me, like, this can’t be as good as you’re saying it is,” he said. “And she didn’t really have anything bad to say.”
Chapman remembers coming off the phone feeling excited and optimistic.
“At that moment it became very real, and also just emotionally I couldn’t deal with this roller coaster ride of having a little bit of good vision for just a month or two, and then going blind again,” he said. “It felt like groundhog day … for 20 years.”
Dr. Greg Moloney, an ophthalmologist with Providence Health Care, said the problem with Chapman’s condition and other candidates like him is the front of the eye has sustained enormous damage, but the back of the eye is healthy.
“The agonizing thing for Brent is that he knows that he can see, and he has moments of being able to see for a few days at a time after we do all these other surgeries, where we restore a clear window in front of the eye,” Moloney said, comparing a damaged cornea to a cracked windshield of a car.
“This surgery is just a very fancy way of replacing the windshield on the front and letting all the light back in,” he said.
Origins of tooth-and-eye surgery remain a mystery
But the tooth-in-eye surgery is a long and very resource-intensive process. Chapman’s first operation happened at the end of February, and Moloney was aided by three other doctors – one who flew from Australia at his own expense to help train the other physicians.
After extracting Champan’s tooth and drilling a hole in it, they put a plastic “optic” through (a cylinder that focuses light). They then stuck the seeing tooth in his cheek, where it sat for three months to be surrounded by body tissue.
The second step, in June, was even more intense. Over the course of a day, the surgical team worked to remove the flesh-encased tooth and attach it to Chapman’s eye.
If you’re wondering if such a surgery was conceived by a deranged mind, or with the help of LSD, Moloney has asked himself the same questions. But the answers will never come, as the Italian doctor who invented tooth-in-eye in the early 1960s, Benedetto Strampelli, is dead.
However, while the fleshy iteration is new, the practice of implanting artificial corneas has been around since1789, Moloney said. There are actually hundreds of versions of that procedure.
“But the problem with all of them is getting that plastic [lens] to be accepted by the eye and by the body,” he said.
That’s when the idea of the tooth starts to make sense, as a biological bridge that holds the optic plastic in place and won't be rejected by the body as a foreign interloper.
As part of his training, a still-skeptical Moloney went to parts of the world like Germany and Italy, where tooth-in-eye surgeries had been done for decades.
“We had dinner with people who’d had the operation in the '70s and '80s. And 30, almost 40 years later, were living normal lives,” he said. “Those meetings really convinced [me].”
Chapman now an advocate for the procedure
For Chapman, the results of his surgery have been life-changing.
On a scale from one to 10, comparing his vision from before the incident after the basketball game to times he couldn’t see at all, Chapman rates his sight now at a strong eight, or even higher.
“I’m very, very grateful,” he said. “We did an adjustment last Tuesday, and since, that it’s just been a world of difference.”
As his rollercoaster ride with vision hopefully fades in the rear view, Chapman is looking forward to expanding his horizons in life to novel activities – like travelling for non-medical reasons, to countries like Japan and the U.K.
Chapman said he will also use his renewed sense of optimism to advocate for tooth-in-eye surgery. Part of that is drawing attention, and potential donor dollars, to the St. Paul’s Foundation – which made his surgery possible. Another part of his advocacy is connecting with other prospective patients.
“There’s someone out there that’s going through what I was going through, and maybe they come across this, and it sets off a chain reaction, and it ends up being positive for them as well … I’d feel good about that,” Chapman said.
“I’m open to speaking to [any] potential candidates,” he said.
[email protected]
twitter.com/nick_laba
@nicklaba.bsky.social
Want to stay updated on North Vancouver and West Vancouver news? Sign up for our free daily newsletter.
