New surgical strategy for corneal tattooing using a femtosecond laser

The purpose of this study was to describe a new method of femtosecond (FS) laser-assisted corneal tattooing and to report the results of this method in a case series.

The study involved 6 eyes of 6 patients with total or partial corneal opacity. An FS laser was used for lamellar dissection and to make a side cut with a hinge, creating a corneal flap. Laser parameters were adjusted depending on ocular condition and the location of the corneal opacity. After lifting the corneal flap, further lamellar dissection with a diamond blade was performed up to the periphery of the limbal area. Using a cannula, dye was injected into the lamellar stromal bed and the space of the lamellar dissected pocket in the limbus, after which the flap was repositioned.

The design and application of the FS laser for dissection and flap creation were successful in all cases. There were no significant complications other than an incomplete cut under band keratopathy in 1 eye. The cosmetic effects were satisfactory in all cases. No patient complained of pain for more than 1 day after surgery.

The advantages of the FS laser-assisted corneal tattooing include a customized design, speed, decreased pain, reduced risk of perforation, and good wound healing. This procedure provides improvements over current corneal tattooing techniques, although it is relatively expensive.