Delhi Journal of Ophthalmology

Corneal Tattooing with India Ink in a Young Male

Manpreet Kaur1, Shakeen Singhr2, Manpreet Singh1
1Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2Sri Guru Ram Das Institute of Medical Sciences & Research, Amritsar, India

Corresponding Author:

Manpreet Kaur MS
Senior Resident,
Post Graduate Institute of Medical Education
and Research, Chandigarh, India
Email id: drmanpreet4j@gmail.com

Received: 15-JUL-2019

Accepted: 27-JUL-2019

Published Online: 27-DEC-2019

DOI:http://dx.doi.org/10.7869/djo.486

Abstract
A 25 -years old male patient underwent left eye squint surgery for exotropia followed by corneal tattooing by India ink to stain the unsightly long standing corneal opacity and obtained a cosmetically satisfying outcome.

Keywords :Corneal tattooing, India ink, Lamellar pocket

A 25-years-old male presented with cosmetic concerns due to total white left cornea of 3 years duration following a blunt ophthalmic trauma. The visual acuity was 0.0 logMAR units in right eye and no light perception and projection of rays in left eye and ultrasound B-scan showed echo-free vitreous cavity and attached retina. Clinical examination showed left exotropia (45°) and a macular corneal opacity involving >1/2 corneal-thickness. Total cornea was involved except for 1mm peripheral circumferential rim (Figure 1A). The right eye was normal. As planned, he underwent a left cosmetic squint surgery followed by the corneal tattooing, after 4 weeks of squint surgery.
A stromal pocket was created in the cornea with the help of a crescent knife. A lamellar dissector was used to complete the stromal pocket. The dye is then poured into the pocket created and distributed uniformly. This surgical technique is called as “lamellar pocket procedure” in which the inner surface of corneal flap and surface of stromal bed were tattooed simultaneously thus duplicating the amount ofpigment deposited in the cornea. Our patient obtained a long-term, cosmetically satisfying outcome (Figure 1B). The use of India ink for colouring the white (ghostly) corneas has been described since years. The lamellar pocket procedure stains both inner surface and the stromal bed providing better outcomes than anterior stromal puncture tattooing method which can damage the basement membrane.1




References
  1. Panda A, Mohan M, Chawdhary S. Corneal tattooing-experiences with “lamellar pocket procedure”. Indian J Opthalmol, 1984; 32:408-411.

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Kaur M, Singh S, Singh MCorneal Tattooing with India Ink in a Young Male.DJO 2019;30:67

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Kaur M, Singh S, Singh MCorneal Tattooing with India Ink in a Young Male.DJO [serial online] 2019[cited 2020 Jan 25];30:67. Available from: http://www.djo.org.in/articles/30/1/Corneal-Tattooing-with-India-Ink-in-a-Young-Male.html