Corneal Tattooing

• Also called Keratopigmentation.

• Impregnation of coloured substances into the corneal stroma to mimic the patient’s iris and central pupillary area.

INDICATIONS:

• Cosmetic purposes.

• For optical purposes to reduce scattering of light.

• To cover iris defects due to trauma/surgery when associated with glare/ diplopia.

CONTRAINDICATIONS:

• Thin corneas/ Corneal ectasias.

METHODS:

1) Chemical reduction method:

• Involves the precipitation of a pigment into the corneal tissues.

• Easier and quicker but the results are less precise.

• Fading of the color is more rapid because the metallic compounds are mainly deposited in the extracellular matrix of cornea thus allowing early fading of the color.

• Chemicals used: Gold chloride (golden brown colour), Platinum chloride (jet black), Gold chloride, Palladium oxide.

2) Direct innoculation method:

• Older and crude method of tattooing.

• More difficult and more time consuming.

• But, it produces more permanent results as compared to the chemical reduction methods.

• This is due to the fact that these dyes tend to be phagocytosed by the keratocytes thus preventing leaching of the dyes.

• Benefits: Easy availability, prevents inadvertent full thickness corneal peforation.

3) Corneal Needle Tattooing with Pigments:

• Lampblack/ India ink used.

• Autoclaved for sterility.

4) Lamellar pocket method:

• Beneficial for cases with a clear superficial cornea.

• A partial thickness incision is made in the peripheral cornea which is extended to a lamellar intracorneal pocket in a plane anterior to the opacity and dye is inserted into the pocket.
  

5) Femto-assisted corneal tattooing (FACT):

• A femtosecond laser is used to make a superficial corneal pocket into which tattoo ink is injected.

• Ink lasts longer and achieve more uniform cosmetic results.

• Limitation: High cost, inability of laser to penetrate opaque cornea.
  

COMPLICATIONS:

• Corneal infection

• Inflammation

• Pain

• Risk of inadvertent globe penetration via entry into the anterior chamber.

www.ophthalmobytes.com⁣

Image from Rajan Eye Care Hospital

⁣

#ophthalmology#ophthal#doctor#health#medical#vision#education#optometry#medicalstudent#optometrist#medicine#eye#ophtho#ophthalmologist#ophthalmo#med#medicaleducation#ophthalmologyresident#ophthalmologyresidency#oftalmologia#surgery#surgeon#apaoyo#cornea#cornealtattoo#cornealtattooing