Issue: July 10, 2013
June 04, 2013
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Femtosecond laser enables faster, easier corneal tattooing

Issue: July 10, 2013
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KIAWAH ISLAND, S.C. — Femtosecond laser-assisted corneal tattooing has shown good early results for patients with aniridia, iris trauma and other disorders, a speaker said here.

“I think this is a very exciting and promising technique. I’m going to be doing a lot more of these. It’s a lot easier than doing it by hand with the needle technique. This is probably the first use of the femtosecond laser where it is completely better,” Keith A. Walter, MD, said at Kiawah Eye 2013. “It’s something that I think has been helpful with a very menacing problem, and also it’s just very cool.”

Conventional corneal tattooing involves the use of a 30-gauge needle to apply titanium dioxide pigment to the cornea. It typically takes 20 to 30 minutes to make 200 to 1,000 needle punctures, Walter said.

The procedure is frequently incomplete, with a high re-treatment rate, and it can be painful. In addition, the pigment fades over time, Walter said.

Walter said he first learned about femtosecond laser-assisted corneal tattooing in a study by Kymionis and colleagues in the February 2009 issue of Cornea.

The femtosecond laser allows the surgeon to make a custom pocket at any location. The surgeon can use ring segment software to make deep channels or create a partial LASIK flap, Walter said.

Walter described his first four cases, which responded well to the femtosecond laser-assisted technique. Channels of 150 µm to 250 µm enabled tattooing with good cosmetic results and rapid recovery. Patients had traumatic injury and visual side effects from ICL (STAAR Surgical) implantation, he said.

Disclosure: Walter receives royalties from Ocular Systems Inc. and is a consultant for Abbott Medical Optics and Bausch + Lomb.