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Corneal Tattooing

- Also called Keratopigmentation.

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


- 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.


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.


- Corneal infection

- Inflammation

- Pain

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

-This procedure is rarely done nowadays.⁣

Image from Rajan Eye Care Hospital


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