Mucosal Overgrowth Research Articles

Survival of dental implants and occurrence of mucosal overgrowth in patients with head and neck cancer treated with/without radiotherapy and mucosal graft—two-year follow-up

ObjectivesThe primary aim of the present study was to compare head and neck cancer treatment modality surgery and surgery with radiotherapy or chemoradiotherapy alone for dental implant (DI) survival. The second aim was to evaluate the prevalence of mucosal overgrowth around DI after treatment with or without mucosal grafts.Materials and methodsAn observational retrospective study consisted of 59 patients with malignant head and neck tumors that received DI between 2015 and 2019. Treatment modalities together with information on oral rehabilitation with DI, prevalence of mucosal overgrowth, and precursor lesions were gathered from the hospital records. Radiation doses were determined using a sum of three-dimensional dose distributions.ResultsOverall DI survival rate was 88%, in irritated jaw 89%, and in nonirradiated jaw 88% in this observational period (p = 0.415, mean follow-up was 2 years 10 months, range 9–82 months). Mucosal overgrowth was found in 42 of 196 implants (21%), of which 36 cases (86%) were associated in grafted areas (p < 0.001). Oral lichen planus/lichenoid reaction was diagnosed in 14 of all 59 (24%) oral cancer patients.ConclusionImplant survival was not significantly influenced by radiation therapy in this observational period. In grafted bone, implant survival was significantly inferior than in native bone. Mucosal overgrowth around implants was more common in mucosal grafted areas versus nongrafted.Clinical relevanceThis study demonstrates the impact of grafted bone to dental implant survival rate and mucosal overgrowth.

Comparison of hybrid arch bar versus conventional arch bar for temporary maxillomandibular fixation during treatment of jaw fractures: a prospective comparative study.

This study aimed to compare the effectiveness of a hybrid arch bar (hAB) with the conventional Erich arch bar (EAB) for the management of jaw fractures, focusing on their use for temporary fixation in patients undergoing open reduction and internal fixation (ORIF). Patients presenting with maxillary and mandibular fractures at our institution were included in this prospective, comparative study. Placement time and ease of occlusal reproducibility were recorded intraoperatively for Group A (hAB patients) and Group B (EAB patients). The primary outcome was comparison of the postoperative stability of the two arch bars. Postoperative measurements also included mucosal overgrowth, screw loosening or wire retightening, and replacement rates. The data were tabulated and computed with a P<0.05 considered statistically significant. The study included 41 patients. A statistically significant difference was observed in postoperative stability scores (3) between Group A and Group B (85.0% vs 9.5%, P=0.001). The mean placement time in Group A (23.3 minutes) significantly differed from that in Group B (86.4 minutes) (P<0.001). The ease of intraoperative occlusion was not different between the two groups (P=0.413). Mucosal overgrowth was observed in 75.0% of patients (15 of 20) in Group A. The hAB was superior to EAB in clinical efficiency, maxillomandibular fixation time reduction, stability, versatility, and safety. Despite temporary mucosal overgrowth, the benefits of hAB outweigh the disadvantages. The choice between hAB and EAB should be based on specific clinical requirements.

1301 What Can Be Done to Minimise the Mucosal Complications of Surgical Intervention Involved in the Treatment of Corneal Blindness Through Osteo-Odonto-Keratoprosthesis

Abstract Introduction Osteo-odonto-keratoprosthesis (OOKP), “tooth-in-eye surgery”, is a rare, complex surgery offered to certain patients with bilateral corneal blindness. Indications for the surgery include and range from: Steven-Johnson syndrome to end-stage ocular surface diseases. OOKP consists of two stages undertaken four months apart. Surgical complications can be divided into intraoperative and following stages 1 and 2. The most common postoperative complications include: Mucosal thinning/ulceration, mucosal overgrowth, and infection. We discuss, preventive methods which can be considered before the stage 2 intervention to minimise the rate of complications post OOKP surgery. Method A literature search was conducted in PubMed and Research gate to determine the main complications following involvement of maxillofacial surgery. Our key search criteria included mucosal complications post maxillofacial and oculoplastic surgical involvement. We selected for complications, post harvestation and transfer of the buccal mucosa onto the eye surface in OOKP. Results Three studies were selected, with a total of 130 patients. 58% experiencing surgical complications following stage 2. Study 1 demonstrated mucosal graft complications (22%), mucosal overgrowth(28%), mucosal thinning and ulceration(22%). Notably, 38% experienced no complications following the second stage. In the remaining studies, post-operative complications were divided into mucosal necrosis (33%) and mucosal overgrowth(13%), showing how complications can often interplay. Conclusions OOKP is a complex and laborious multi-disciplinary surgery, amenable to postoperative complications. Mucosal complications occur in a significant number of cases; therefore, it is important to anticipate these and endeavour to avert them. We outline how through prudent patient selection and pre-operative patient care (promotion and correction of dentition and oral health, examination of oral mucosa and maintenance of good mucosal graft health), outcomes for this surgery can be significantly improved.

Pseudo bezoar in an elderly man

Indigestible intra-gastric foreign bodies are encountered in the mentally deranged, transporters of illicit drugs or those desiring weight control. They are often complicated by obstruction, migration, or perforation. Pseudobezoars are indigestible objects introduced intentionally into the digestive system. They may be indicated in bariatric practice for control of obesity. We present an 87-year-old man managed for a 2-year history of burning epigastric pain, aggravated by lying down and relieved by antacids. He had associated reflux symptoms for which he adopted lifestyle modifications. He had an upper gastrointestinal endoscopy which showed a stone attached to the anterior wall of the body of the stomach with associated pseudo-pouch formation. Mucosal overgrowth on the stone could be noted. Attempts at endoscopic retrieval failed as the stone could not be dis-impacted from its lodgement in a mucosal pouch. He had a laparotomy and gastrotomy for retrieval. A piece of stone, identified as granite, which measured 2 × 2 × 2.5 cm was retrieved from the stomach with accompanying formation of the mucosal pouch. Mucosal response, which may include overgrowth, could be an initial step in the migration of intra-gastric foreign bodies.

Anterior maxillary gingival overgrowth with associated submandibular lymphadenopathy

A 50-year-old Saudi woman presented to the Department of Oral and Maxillofacial Surgery, King Saud University Dental Hospital, Riyadh, Saudi Arabia, with a mucosal overgrowth related to the labial gingiva of the right maxillary second incisor and canine of about 10 months’ duration. The mass was slow-growing with no associated recent rapid growth before presentation. There was no history of trauma to the area. The patient was a known shammah (smokeless tobacco) user for over 40 years, usually placed alternately in the right and left anterior mandibular vestibule in the canine-premolar area.

Dermatologic findings in individuals with genetically confirmed Proteus syndrome.

Proteus syndrome, caused by a mosaic activating AKT1 variant, typically presents in toddlers with progressive, asymmetric overgrowth of the skin and bones. We aimed to define the spectrum of dermatologic disease in individuals with genetically confirmed Proteus syndrome. We conducted a retrospective review of records from dermatologic examinations of individuals evaluated at the NIH with a molecular diagnosis of Proteus syndrome. The types, prevalence, and localization of dermatologic findings were assessed. Fifty-one individuals (29 males, 22 females, mean age: 9years) with clinical features of Proteus syndrome had the mosaic c.49G>A, p.Glu17Lys AKT1 variant. Fifty (98%) had at least one cutaneous feature constituting current clinical diagnostic criteria, including vascular malformations in 42 (82%), epidermal nevus in 41 (80%), volar cerebriform connective tissue nevi in 34 (67%), and adipose dysregulation in 30 (59%). Forty-nine (96%) had at least one dermatologic finding not included within the diagnostic criteria, including confluent volar skin-colored to hypopigmented papules or nodules (n=33, 65%), papules or nodules on the digits or face (n=27, 53%), and nonlinear epidermal nevi (n=15, 29%). Other frequently observed features include nail changes (n=28, 55%), hyperpigmented macules (n=27, 53%), patchy dermal hypoplasia (n=18, 35%), gingival/oral mucosal overgrowth (n=17, 33%), hypopigmented macules (n=16, 31%), dental enamel changes (n=9, 18%), acrochordons (n=6, 12%), and lingual overgrowth (n=4, 8%). The range of mucocutaneous features occurring in Proteus syndrome is broader than previously considered. These observations may assist in earlier diagnosis and management and provide novel insights regarding the pathogenesis of the condition.

Complications reported with the use of orthodontic miniscrews: A systematic review.

ObjectiveThe aim of this systematic review was to evaluate the complications and side effects associated with the clinical use of orthodontic miniscrews by systematically reviewing the best available evidence.MethodsA survey of articles published up to March 2020 investigating the complications associated with miniscrew insertion, in both the maxilla and mandible, was performed using 7 electronic databases. Clinical studies, case reports, and case series reporting complications associated with the use of orthodontic miniscrew implants were included. Two authors independently performed study selection, data extraction, and risk-of-bias assessment.ResultsThe database survey yielded 24 articles. The risk-of-bias assessment revealed low methodological quality for the included studies. The most frequent adverse event reported was root injury with an associated periradicular lesion, vitality loss, pink discoloration of the tooth, and transitory loss of pulp sensitivity. Chronic inflammation of the soft tissue surrounding the miniscrew with mucosal overgrowth was also reported. The other adverse events reported were lesion of the buccal mucosa at the insertion site, soft-tissue necrosis, and perforation of the floor of the nasal cavity and maxillary sinus. Adverse events were also reported after miniscrew removal and included secondary bleeding, miniscrew fracture, scars, and exostosis.ConclusionsThese findings highlight the need for clinicians to preliminarily assess generic and specific insertion site complications and side effects.

The Use of Screw Retained Hybrid Arch Bar for Maxillomandibular Fixation in the Treatment of Mandibular Fractures: A Comparative Study.

Introduction:The use of screw-retained hybrid arch bars (HABs) is a relatively recent development in the treatment of mandibular fractures. The purpose of this study is to compare the clinical outcome between HAB and the conventional Erich arch bar (EAB) in the closed treatment of mandibular fractures.Materials and Methods:This study included 18 patients who were treated for mandibular fractures with maxillomandibular fixation (MMF), patients were randomly assigned into a control group (n = 10) in which EAB was used and study group (n = 8) in which HAB was used. The outcome variables were time required for application and removal, gingival inflammation scores, postoperative complications, and incidence of wire-stick injury or gloves perforation. The groups were compared using unpaired t-test, Mann–Whitney test, Chi-square test, or Fisher test. The differences were considered significant at P < 0.05.Results:The mean application time was significantly more in EAB than HAB (61.6 ± 11.4 vs. 41.6 ± 6 min, respectively). The mean time of removal for EAB was significantly less than HAB (11.1 ± 2 vs. 14.2 ± 3 min, respectively). There was nonsignificant difference in gingival inflammation between the groups. No major complications were recorded. Screw loosening and mucosal overgrowth were recorded in 12.5% and 31.2% of the screws, respectively, in HAB group. The incidence of gloves tear in EAB group was 70%.Discussion:HAB can be used as an alternative to EAB for MMF in patients with mandibular fracture, it requires less time for application and provides more safety for the surgeons.

Methods for Endoscopic Removal of Over-the-Scope Clip: A Systematic Review.

Aims The over-the-scope clip (OTSC) has recently emerged as a new endoscopic device for treating gastrointestinal bleeding, perforations, fistulas, and leaks. A modified OTSC device (full-thickness resection device, FTRD) has been widely used for endoscopic full-thickness resection. However, there is less experience regarding the indications and methods for OTSC removal. We aimed to summarize the existing methods and indications for OTSC removal. Methods We searched PubMed, Cochrane Library, and ClinicalTrials.gov to identify relevant publications on OTSC removal. The details of OTSC removal, including the methods, indications, success rates, adverse events, and failure causes, were extracted and summarized. A meta-analysis of pooled success rates was conducted using STATA 15.0. Results Eighteen articles were included. The reported methods for OTSC removal included (1) grasping forceps, (2) the Nd : YAG laser, (3) argon plasma coagulation, (4) the remOVE system, (5) endoscopic mucosal resection/endoscopic submucosal dissection, and (6) ice-cold saline solution. Indications for OTSC removal were (1) poor healing, (2) OTSC misplacement, (3) repeat biopsy/therapy or further treatment, (4) adverse events after OTSC implantation, (5) removal after recovery, and (6) patient wishes. The pooled success rate of OTSC removal was 89% in patients treated with the remOVE system. Minor bleeding, superficial thermal damage, and superficial mucosal tears were common adverse events. Mucosal overgrowth was the main cause of OTSC removal failure. Conclusions The remOVE system is the best investigated method, with sufficient efficacy and safety for OTSC removal. This is the first systematic review of OTSC removal and provides significant guidance for clinical practice.

Self-Retained Voice Prosthesis in the Decompression of the Odontogenic Keratocyst: A Technical Note

Decompression of the odontogenic keratocyst has been a long-standing treatment modality in the armamentarium of oral-maxillofacial surgeons. Many different types of effective decompression tubes have been described in the literature. They reduce the size of the cystic lesion by decreasing the intraluminal pressure, induce histologic structural changes in the epithelial lining of the cyst, and allow for bone deposition to occur from the periphery of the cystic cavity. However, many of these have pitfalls including tube dislodgement, traumatization of the oral mucosa, and mucosal overgrowth. We describe a novel technique using an indwelling voice prosthesis (Inhealth Technologies, Carpinteria, CA) to decompress odontogenic keratocysts. We found that our method provides effective decompression using appropriate-length prostheses fit to the cyst dimensions. It provides improved comfort in patients, with less mucosal irritation or overgrowth, improved ease of irrigation, and improved retention that often does not require sutures.

Management of adverse events of EUS-directed transgastric ERCPprocedure.

Background and AimsAccessing the pancreatobiliary region in patients with a history of Roux-en-Y gastric bypass (RYGB) can be challenging. Traditionally, techniques such as percutaneous biliary drainage, enteroscopy-assisted ERCP, and laparoscopy-assisted ERCP have been used. However, each technique has its limitations. EUS–directed transgastric ERCP (EDGE) using a lumen-apposing metal stent (LAMS) has emerged as a novel endoscopic technique for ERCP in patients who have undergone RYGB. The aim of this case series was to highlight LAMS-related shortcomings and adverse events during the periprocedural period.MethodsThis was a retrospective review of 4 patients with RYGB anatomy who underwent EDGE for the management of pancreaticobiliary disease and experienced LAMS-related adverse events. Techniques for managing and avoiding these events are discussed.ResultsFour patients underwent EDGE with both technical and clinical success. Slight LAMS migration with partial mucosal overgrowth was encountered in 1 case and was managed by LAMS removal. A large, bleeding, distal marginal ulcer after the EDGE procedure was encountered in the second case and was managed with proton pump inhibitor and removal of the LAMS, with fistula treatment with argon plasma coagulation used to enhance closure. The third case was complicated by moderate intraprocedural bleeding after LAMS dilation, which was managed by applying balloon tamponade and placing a through-the-scope esophageal stent across the LAMS. Last, preferential food passage to the excluded stomach was noted in the fourth case and resulted in symptomatic distention. The symptomatic distention was managed by another de novo jejunogastrostomy using a LAMS for drainage.ConclusionsDespite its feasibility and acceptable safety profile, the use of LAMSs during EDGE could be associated with several procedure-specific adverse events, which can be avoided or managed endoscopically with no further consequence.

Mucosal complications in osteo-odonto keratoprosthesis (OOKP) surgery

Abstract Purpose To study the mucosal complications of osteo-odonto-keratoprosthesis (OOKP) surgery from the UK national keratoprosthesis cohort. Methods A retrospective study was conducted at the Sussex Eye Hospital, Brighton, UK. The case records of patients who underwent OOKP surgery were reviewed and analysed. Results The cohort contained 64 patients, among which 25 were females and 39 were males. Eyelid and adnexal abnormalities were treated in 69% of the cases prior to OOKP surgery. Mucosal graft complications after OOKP affected 46% of the cases after stage 1 and 22% after stage 2. Most of the complications were observed in cases with autoimmune conditions like Stevens-Johnson syndrome (43% post-stage 1, 59% post-stage 2) and cicatrising conjunctivitis (31% post-stage 1, 20% post-stage 2). On the contrary, mucosal overgrowth covering the anterior surface of the optic, which was noted in 28% of the cases, was a common complication after stage 2. Thinning and ulceration of the mucosa was noted in 22% of cases after stage 2. Laminar exposure due to mucosal ulcers was identified in 11 cases. The central part of the mucosa was frequently affected by thinning and ulceration after stage 1. The mucosa overlying the supero-nasal corner of the lamina was eroded commonly after stage 2 leading to exposure of the lamina. Mucosal thinning after stage 1 was treated with conservative measures such as observation and increased lubrication in 15 cases, and with surgical procedures in 7 cases. Post-stage 1 mucosal ulcers were mostly treated by surgery (7 out of 8 cases). Following stage 2, minor cases of mucosal ulcers and thinning and three cases of overgrowth were conservatively treated with lubrication and observation. However, 18 cases of overgrowth required surgical excision. All cases of lamina exposing ulcers were surgically treated. Surgical treatment of mucosal defects included mucosal grafts, flaps and eyelid corrections. Fusion of the eyelids and conversion to a trans-palpebral OOKP were performed in two cases to treat resistant mucosal ulcers. Two eyes lost lamina as a consequence of lamina exposing ulcers. One lamina was explanted due to severe resorption and one due to infection. Conclusion The majority of surgical revisions following OOKP surgery are due to mucosal problems, such as mucosal thinning and ulcerations. These may be treated with increased lubrication of the mucosa or surgical closure of the defects. Mucosal defects resulting in laminar exposure can be a serious threat to laminal viability, and must be treated promptly and aggressively.

Amlodipine-induced gingival overgrowth in the peri-implant region: a review and case report

Gingival overgrowth is a known side-effect of the antihypertensive drug amlodipine, but the risk of mucosal overgrowth around dental implants has been less well documented. This article discusses the role of calcium channel blockers in drug-induced mucosal overgrowth around dental implants and describes the preventive and surgical management of the case. CPD/Clinical Relevance: The report describes the management of a patient with an implant-supported restoration who presented with peri-implantitis and drug-induced mucosal overgrowth. The review discusses how amlodipine and other medications, commonly associated with drug-induced gingival overgrowth, impact on the management of implant patients.

Piezoelectric harvest of osteo-odonto-lamina in modified osteo-odonto keratoprosthesis: A maxillofacial perspective.

Purpose:We describe the piezo-osteotomy feasibility in rehabilitation and harvesting of osteo-odonto lamina in modified osteo-odonto keratoprosthesis (MOOKP) surgery. Surgery was evaluated regarding operative technique and success of the keratoprosthesis (KPros) in terms of perception to light (+ve) to finger counting (+ve).Materials and Methods:This retrospective cohort study included 12 patients undergone MOOKP surgery procedures. Harvesting of osteo-odonto-lamina was performed using piezosurgical osteotomy during 2007–2012.Results:The mean follow up was 34 months (range 24–48 months). Of the 12 patients six patients had vision ≥6/12, four patients had vision <6/12, but >6/60 and one patients had vision ≤6/60. KPros was retained and functional in all the eyes after a minimum follow up of 24 months. There was mucosal overgrowth over the optical cylinder occurred in two cases over 4 years follow up which was corrected with trimming. Postoperative complication at donor site was seen in three cases, two cases with exposure of root of adjacent teeth and oro antral fistula in one.Conclusions:This study suggests that piezoelectric harvest of osteo-odonto-lamina is a valuable surgical option in patients undergoing MOOKP surgery, resulting in high success rate with less complication.

Novel endoscopic management of buried bumper syndrome in percutaneous endoscopic gastrostomy: The Olympus HookKnife.

Buried bumper syndrome (BBS) is an uncommon but serious complication of percutaneous endoscopic ga-strostomy. It involves the internal fixation device, or “bumper”, migrating into the gastric wall and subsequent mucosal overgrowth. We described a case series of four patients with BBS treated with a novel endoscopic technique using a HookKnife between June 2016 and February 2017. The HookKnife is a rotating L-shaped cutting wire designed for hooking tissue and pulling it away from the gastric wall towards the lumen. The technique was successful in all four cases with no complications. Each patient was discharged on the day of treatment. The HookKnife is a manoeuvrable, safe and effective device for endoscopic removal of buried bumpers and could avoid surgery in a high risk group of patients. To our knowledge this technique has not been described previously. We suggest that this technique should be added to the treatment algorithms for managing BBS.

PYOGENIC GRANULOMA IN ADVANCED CHRONIC PERIODONTITIS: EXCISIONAL BIOPSY PRIOR TO NON-SURGICAL PERIODONTAL TREATMENT

The pyogenic granuloma is a reactive non-neoplastic lesion typically found as a painless mucosal overgrowth that easily bleeds because of its high vascularization. Herein we report a case of periodontal breakdown and pyogenic granuloma in a 38-year-old female patient. Clinical examination revealed an exophytic lesion in the interdental gingiva of teeth 42 and 43, with 2 cm in its largest diameter, pediculated, with 3 years of evolution. Calculus formation was detected in the neighboring teeth. Root scaling and excisional biopsy was performed under local anesthesia. All removed tissue was submitted to histopathologic analysis that confirmed the diagnosis. The patient is under periodontal control for 9 months with no signs of recurrence.

Irritable Bowel Syndrome, Emotion Regulation, and Gut Microbiota

Irritable bowel syndrome (IBS) is defined as a representative functional gastrointestinal disorder which is characterized by chronic or recurrent abdominal pain and/or abdominal discomfort associated with abnormal bowel movement. Gut microbiota are related to the pathophysiology of IBS. In the field of IBS, post-infectious etiology, stress-induced alteration of microbiota, increased mucosal permeability, bacterial overgrowth, disease-specific microbiota, microbial products, and brain-gut interactions are being investigated. In some individuals, IBS develops after recovery from acute gastroenteritis known as post-infectious IBS. Gut microbiota in IBS patients differ from those in healthy individuals, and the profiles of gut microbiota in IBS patients also vary among IBS patients with constipation, diarrhea, and mixed subtypes. In Japan, gut microbiota in IBS patients also differ from those observed in healthy individuals, and organic acid by-products observed in the patients correlated with symptoms, quality of life, and alexithymia. Further research on gut microbiota in IBS patients is warranted.

Mucosal Complications of Modified Osteo-odonto Keratoprosthesis in Chronic Stevens-Johnson Syndrome

To describe clinical outcomes of complications afflicting the autologous oral mucous membrane graft after modified osteo-odonto keratoprosthesis surgery in chronic Stevens-Johnson syndrome (SJS). Prospective case series. This study included 30 eyes of 30 patients with SJS-induced dry keratinized ocular surfaces; the patients underwent various stages of this procedure between August 2009 and February 2012. Mucosal complications were classified as either necrosis or overgrowth. Mucosal necrosis was managed according to a predesigned algorithm based on timing (pre- and postimplantation) and location (central or peripheral) of necrosis. Cases with mucosal overgrowth underwent mucosal debulking and trimming. Mucosal necrosis developed in 15 (50%) eyes and overgrowth in 4 (13.3%) eyes. Preimplantation necrosis (n = 7) was initially managed conservatively, but 2 eyes required free labial-mucous membrane grafting for persistent corneal exposure. Free labial-mucous membrane grafting was performed in all cases of postimplantation necrosis (n = 10), but 8 eyes required additional tarsal pedicle flaps (n = 6, for peripheral necrosis) or through-the-lid revisions (n = 2, for central necrosis). Debulking and trimming effectively managed all cases of mucosal overgrowth, but 3 eyes required repeat procedures. At 24.1 ± 6.5 months postimplantation, the keratoprosthesis was retained in all eyes, and the probability of maintaining 20/60 or better vision was similar in eyes with or without mucosal necrosis (86 ± 8.8% vs 80 ± 10.3%). Mucosal complications, especially necrosis, occurred commonly following modified osteo-odonto keratoprosthesis surgery in dry keratinized post-SJS eyes. The algorithm-based management approach described in this study was successful in treating these complications, retaining the prosthesis and preserving useful vision.

Therapie eines „Buried Bumpers“ mittels NOTES - ein Fallbericht

Mucosal overgrowth and migration of the inner bumper into or even through the gastric wall (= buried bumper syndrome) is a possible complication of percutaneous endoscopic gastrostomy (PEG). In this case report we describe the successful endoscopic recovery of an intraabdominally migrated inner bumper as well as reestablishment of PEG using NOTES (Natural Orifice Translumenal Endoscopic Surgery). This practical application of the NOTES technique via the preexisting transgastric approach (PEG) can therefore be a reasonable alternative to a surgical-laparoscopic therapy of the severe buried bumper.

Preventing complications of OOKP surgery

AbstractOsteo‐odonto‐keratoprosthesis (OOKP) is the procedure of choice for end stage ocular surface disease with severe dryness and keratinisation, and in those eyes with structural and functional lid abnormalities. The device retention rates and visual outcomes of the OOKP are far superior than any other keratoprosthesis. However, this device can have complications at every step during surgery and unto many years afterwards. Complications after the Stage 1 include: mucosal thinning and ulceration, mouth related, resorption of the implanted lamina and infections. Complications after the Stage 2 include: mucosal thinning and ulceration, mucosal overgrowth onto the optic, lid malpositions, lamina problems like resorption, tilting, infection, posterior segment complications like retinal detachment and vitreous haemorrhage. Glaucoma is a major cause of visual loss in a successful OOKP eye. Social and psychological complications can arise after visual restoration or the preexisting problems can continue. In addition, operative complications, systemic morbidity and anesthetic related problems do occur. A majority of the complications can be sight threatening if not rectified appropriately in a good time. They may be preventable or reducible with correct patient selection, improvements in preoperative and postoperative patient care and education. A sound surgical technique, reflective learning, harnessing the medical technology and multidisciplinary team approach can effectively reduce and treat the complications of OOKP surgery. Multidisciplinary team approach, having an experienced anesthetist and psychologist on board, and a continuous social support will prevent patient morbidity and optimise good outcomes.