Superficial Keratopigmentation: An Alternative Solution for Patients With Cosmetically or Functionally Impaired Eyes

To report the use of different superficial keratopigmentation (KTP) techniques for restoring or enhancing cosmetic appearance of eyes impaired for several reasons.

This is a retrospective, consecutive, noncomparative interventional series of cases, in which 136 cosmetically disabled eyes (due to different corneal abnormalities) of 130 patients were included. A total of 222 procedures of superficial manual KTP and superficial automated KTP were performed. The procedures were divided into 2 groups: first and second-stage procedures. The patients' cosmetic appearance and satisfaction were evaluated and graded as excellent, good, or poor.

A total of 222 procedures were performed, 57.2% were superficial automated KTP, 22.5% were superficial manual KTP, and 20.3% included the combination of superficial KTP with other KTP techniques. Six procedures were purely cosmetic, 16 therapeutic functional, and 200 therapeutic cosmetic. Superficial KTP, as a second-stage procedure, was performed in 13 eyes that were previously pigmented by intrastromal techniques. Superficial KTP as an initial indication (first-stage procedure) alone or in combination with another KTP technique in the same surgery was performed in 123 eyes, in which 44.7% of them were reoperated once or more. Best-corrected visual acuity changed insignificantly, and the intraocular pressure decreased significantly in all the studied groups. No intraoperative complications were observed, 11.2% of eyes with a follow-up time of more than 3 months developed postoperative complications. Most of the patients (98.5%) were satisfied.

The modern superficial KTP procedure provides the possibility to improve the cosmetic appearance of impaired eyes, as an alternative to evisceration, enucleation, prosthetic contact lenses, or keratoplasty.