Corneal tattooing revisited: excimer laser in the treatment of unsightly leucomata

Abstract

Background: Corneal tattooing, a procedure first used by Galen in the treatment of unsightly leucomata, has in recent times received relatively little attention due to major advances in intraocular and corneal surgery. Resurrection of the technique, however, may be reasonably considered in 'high risk' cases of leucomata or leucocoria where corneal transplantation would lead to rejection and failure, or, in eyes with no visual potential, where removal of cosmetically unacceptable dense, white cataracts carries an unreasonable risk of phthisis bulbi or sympathetic ophthalmitis.

Methods: Corneal tattooing requires the accurate and limited removal of corneal epithelium to act as the tattoo bed and unfortunately, if removal of the epithelium exceeds, or goes beyond the circumference of, the chosen area, a ragged cosmetically less pleasing 'pupil' is created. The excimer laser appears to be an ideal tool to create a perfectly circular corneal bed to improve upon older techniques.

Conclusion: We report, for the first time, an updated, simple and improved technique for successful corneal tattooing using excimer laser technology.