Corneal Tattooing and Anterior Stromal Puncture for Treating Symptomatic Bullous Keratopathy

Abstract

Corneal tattooing with Chinese ink is a simple, effective outpatient procedure for treating painful BK in eyes with no visual potential.

Intrastromal Injection of China Painting Ink in Corneas of Male Rabbits: Clinical and Histological Study

“…Lin et al in their study of corneal tattooing, through anterior stromal puncture for managing painful bullous keratopathy and after follow-up period of 26 months, recurrent bullae formation occurred in 3 of 31 patients (9.68%) [ 19 ] who had undergone corneal tattooing that may match with our study in absence of inflammatory cells in histological analysis. In the current study we noticed no fading in the color of the corneal tattooing and the size and shape of pigmentation are the same all over the follow-up period.…”

Effect of intraoperative optical coherence tomography on anatomic and cosmetic results of intrastromal tattooing

“…[ 1 5 7 12 19 ] Our study also demonstrated that i-KTP can be a successful primary method of cosmetic correction in phthisical eyes and eyes with calcific corneal deposits, corneal neovascularization (deep or superficial), and impeded corneal epithelization, etiologies usually excluded in prior studies. [ 1 7 19 ]…”

“…[ 5 ] Concomitant procedures such as strabismus surgery, BSK removal, and ED with ASP were also performed successfully with i-KTP with minimal fear of perforation in our study, thereby reducing the need for more extensive and invasive reconstructive ocular procedures. [ 1 5 7 12 19 ] Our study also demonstrated that i-KTP can be a successful primary method of cosmetic correction in phthisical eyes and eyes with calcific corneal deposits, corneal neovascularization (deep or superficial), and impeded corneal epithelization, etiologies usually excluded in prior studies. [ 1 7 19 ]…”

“…[ 3 6 11 15 16 ] Numerous techniques described to introduce carbon-containing coloring agent into the corneal stroma include multiple micropunctures guided by needle, manual dissection, microkeratome-assisted flap creation, or lamellar keratectomy. [ 7 11 12 13 14 17 18 19 ] However, all these techniques have difficulty in accurately predicting the depth traversed by the needle or the blade due to their blind nature and can result in inadvertent damage to Bowman's membrane or corneal perforation. [ 11 20 ] Utilizing advanced microsurgical methods such as femtosecond laser and intrastromal corneal rings for the creation of intrastromal pockets may also be limited by doubtful penetration of the former through the dense corneal opacities and risk of perforation with the latter in eyes with irregular corneal thickness or adherent leukomas, alongside their inflated cost and limited availability.…”

Simple and novel technique of using lampblack soot as a corneal tattoo for disfiguring corneal opacities

“…Different tattooing methods have been used such as chemical dyeing, using gold or platinum chloride, and nonmetallic tattooing with India ink, China ink, lampblack, and other organic dyes. [ 2 3 ] Numerous methods of performing corneal tattooing have been described in the literature like anterior stromal puncture, lamellar pockets, intrastromal air injection, microkeratome, and femtosecond-assisted creation of lamellar pockets. [ 4 5 6 ]…”