Corneal tattooing
Many different methods and procedures exist today, and there are varying opinions concerning the safety or success of this practice.
Corneal opacities (scarring of the cornea that creates an opaque or semi-transparent area on the eye) may be caused by leucoma, keratitis or cataracts.
[2] According to Dr. Samuel Lewis Ziegler, indications for treatment include albinism, aniridia, coloboma, iridodialysis, keratoconus, or diffused nebulae of the cornea.
[1] Corneal tattooing is also performed on patients who still have vision to reduce symptomatic glare associated with large iridectomies or traumatic iris loss.
[8] After Galen's reference to corneal tattooing in the 2nd century, the practice is not mentioned until 1869, when oculoplastic surgeon Louis de Wecker introduced a new method.
He applied cocaine to the eye as a topical anesthetic, coated the cornea with a thick solution of ink, and inserted pigment into the corneal tissue obliquely with a grooved needle.
Morax split the corneal tissue into two vertical layers, introducing the coloring substance under the pedicle flap and placing a compressive dressing over the eye.
[3] Physicians agree that the tattoo should be injected intramellarly or laterally, which provides an appearance of a uniform color and minimizes the chance of an irritable eye.
[10] Another method, introduced by Arif O. Khan and David Meyer in an article in the American Journal of Ophthalmology, suggests the removal of the corneal epithelium first.
He used a small steel pen manufactured by Joseph Gillott, with the point converted into the cutting surface.
Walter Sekundo et al., in the British Journal of Ophthalmology, say that dyeing is easier and quicker than carbon impregnation, but it fades more rapidly than non-metallic tattooing.
[13] Snejina Vassileva and Evgeniya Hristakieva, both faculty members at universities in Bulgaria, say that India ink is safe and long lasting when properly diluted and is the most commonly used today.
Ji-Eun Lee et al., in an article from Acta Ophthalmologica Scandinavica, say, "Corneal tattooing by intrastromal injection of India ink into the amniotic membrane space may be a very useful method of achieving a good cosmetic report.
Corneal tattooing may also reduce a glare within the eye due to iris loss and increase visual acuity.
Roy, a professor at the University of Montreal, wrote in the Canadian Medical Association Journal, "Placing a bandage over the tattooed eye is not indicated; ordinary coloured glasses are amply sufficient."
Roy says, "All leucomas do not equally respond to intervention, which must be done only on those which present old, solid and flat corneal cicatrices.
[13] Also, advances in technology have decreased the probability of developing a dense corneal leucoma, such as chemotherapy, antibiotics, and the avoidance of "heroic measures of therapy.
[13] More recently Jorge Alió described a technique combining keratopigmentation and the use of a femtosecond laser in the treatment of essential iris atrophy.
[5] An alternative way to permanently change the color of the eye is called BrightOcular, which is achieved by placing an artificial silicone lens on top of the original iris.
The method also makes it possible to remove the implant later in life to get the original eye color back.
