Corneal tattooing is a surgical technique used to manage corneal leukomas and other pathological changes involving the cornea or iris. This method has a long history stretching back to ancient times and its primary goal is to improve the affected eye's appearance.
The reasons for receiving the treatment differ from patient to patient. In most cases, it's to change the eyes' cosmetic appearance after an accident or disease. The procedure can also be used for optical purposes, including:
- Diffused nebulae of the cornea
- Reducing circumstantial glare in the iris due to traumatic iris loss or large iridectomies
The most significant reason for eye tattooing is to improve the cosmetic appearance in patients affected by disfiguring corneal opacities, i.e., the scarring of the cornea that forms semi-transparent or opaque areas on the eye. They are caused by cataracts, inflammation of the cornea or leucoma, and can be cosmetically disruptive for many patients in their daily lives. The treatment can change the discoloration and blend an opacity with the natural eye color.
Also Known As
- Eye tattoo
- Corneal keratopigmentation
Before the Procedure
The eye surgeon will perform a comprehensive eye exam to determine the patient's eye health and assess whether the method is a suitable option. Most doctors only recommend the procedure for patients who have lost their vision or those who don't expect to recover it. It can be a valuable treatment option for a select group of patients whose reconstructive surgical and non-surgical procedures, such as contact lenses, will not provide cosmetic or functional improvement.
Eye tattooing is an outpatient procedure that involves inserting pigment into the middle layer of the cornea, the stroma, to alter the affected eye's appearance. Several methods use a variety of ink pigments to produce the best cosmetic and functional results. The latest femtosecond laser technology-assisted KTP surgical techniques use biocompatible micronized mineral pigments. They are believed to be more convenient, efficient, and safer because they are not linked to significant sight-threatening complications.
Today, there are a variety of eye tattooing methods that use different techniques and instruments. In general, the therapy is performed under topical anesthesia, and the dyeing agent is administered directly to the cornea. An eyelid speculum is put on the patient's eye to prevent it from blinking, and the tattoo expert works on the patient's eye. For example, s/he may inject the ink into the stroma through multiple punctures, applying ink on the needle each time, or use a three-edged spatula needle, covering it with ink before each puncture. Depending on the method being used, s/he may employ a particular device to rub in ink.
Risks & Complications
Some of the risks associated with the technique include:
- Loss of vision
- Toxic reaction
- Corneal infection
- Corneal ulceration
- Swelling of the cornea
- Recurrent corneal erosions
- Persistent corneal epithelial defects
- Accidental puncturing of the eyeball
The patient may experience eye pain, headache, foreign body sensation and increased sensitivity to light for some hours following the procedure.
Several complications may arise with the eye tattooing, including:
- Secondary pigmentary glaucoma
- Inflammatory foreign body reaction
- Ink moving into the aqueous compartment leading to the coating of the corneal endothelium, lens and trabecular meshwork, the eye drainage tissue
After Care & Recovery
The doctor may prescribe antibiotics to prevent infection and provide aftercare instructions. It's important to prevent water from getting into the eye and to avoid rubbing the eyes after the treatment. The doctor may see the patient a day after the procedure to assess the results and check for any complications. The recovery should take a day or so, and follow up will depend on the condition of the patient.
In some cases, the results may be short term or unsatisfactory, and the eye has to be re-tattooed. It's also essential to remember that the size of the tattooed area decreases and fades over time; it rarely remains permanent.