I tried this again hoping for an update, seeing it still doesn't work I went to Google.
I found that you can get an extension from BTTV themselves. Just go to their website and hit Add to Opera. Odd it doesn't show up in results when you search for it.
It also works, just have to refresh if you're already in a stream.

Well tried what previous comments have said, I can't get the BTTV emotes to work.
@zorlonder posted a link but the extension is no longer available sadly. If anyone knows a troubleshoot I would love to hear it.