Objective, Subjective And Refractive Effects Of A Cosmetic Surgical Intrastromal Keratopigmentation (Corneal Tattooing) In A Patient With Previous Presbyopia Intraocular Surgery
Published 2023 - 41st Congress of the ESCRS
Reference: PP15.17 | DOI: 10.82333/75j9-cw74
Authors: Maria Angeles Del Buey* 1 , Sara Marco 2 , Paula Casas 2 , Nuria López-Rodríguez 2 , Guillermo Pérez-Rivasés 2 , Enrique Mínguez 2 , Francisco. J Ascaso 3
1Ophthalmology,Hospital Clínico Universitario "Lozano Blesa",Zaragoza,Spain;Surgery department,University of Zaragoza,Zaragoza,Spain;Ophthalmology,Aravis ,Hernán Cortés Hospital ,Zaragoza,Spain, 2Ophthalmology,Hospital Clínico Universitario "Lozano Blesa",Zaragoza,Spain, 3Ophthalmology,Hospital Clínico Universitario "Lozano Blesa",Zaragoza,Spain;Surgery department,University of Zaragoza,Zaragoza,Spain
To report the objective, subjective and refractive effects produced by a cosmetic corneal tattoo procedure in a patient who had a previous intraocular multifocal lens implantation.
Department of Ophthalmology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
ARAVIS Ophthalmology, Hernan Cortes Hospital Group (HC Miraflores), Zaragoza, Spain.
We describe a case of a female patient of 55 years old, who claimed that she had slight blurry vision and loss in the peripheric visual field related to a cosmetic surgery to change the color of the eyes.
In her ophthalmic history we found that, seven years ago, she had a presbyopia intraocular surgery in our clinic, when multifocal lenses were implanted in order to correct hyperopia and presbyopia. At that time a final emmetropic result was reached with a visual acuity (VA) of 20/20.
As an ophthalmological examination we performed a visual and refractive exam, followed by a slit lamp examination, a visual field exam, funduscopic examination, retinoscopy and an anterior segment (AS) and retinal OCT.
We observed white pigment deposits in the cornea, located in a large circumferential stromal pocket, leaving free the pupil area. The anterior chamber and fundoscopy examination were difficult as a result of the density of the pigment.
The SA-OCT showed a lineal hyperreflective intrastromal area in the anterior third of the medial and peripheral cornea.
A decrease in sensitivity was observed in the peripheral visual field, which would correspond to the subjective perception of blurred peripheral vision.
Visual exam showed a bilateral loss in VA, from 20/20 (last exam) to 20/40 currently. An undescribed hyperopic bilateral error (+1.00D in the right eye and +0.75 in the left eye) was detected, that we related to the last surgical procedure.
Surgical intrastromal keratopigmentation is a cosmetic procedure, that changes the color of the eye. Nevertheless, it can cause unwanted subjective and refractive effects in the postoperative period. This case describes the hyperopic refractive error that can take place after this procedure. More studies to analyse the consequences of corneal tattooing in the medium and long term are needed.