Abstract
Purpose:
Recent reports have alerted eye care providers and the general public about the danger of certain eye whitening procedures that involve a combination of removing generous areas of conjunctiva, cautery, laser and/or using antimetabolites. This study explores the possibility of an alternative procedure involving subconjunctival injections which could be used to whiten the eyes and avoid the risks associated with previously described techniques.
Methods:
Cadaver ocular specimens were obtained from a reputable medical animal supplier. Tattoo ink was obtained from a commercially available source. Photography was used for documentation. The subconjunctival space was entered using a 25 gauge needle and balanced salt solution was injected to balloon up the conjunctiva. The ink was then injected into the subconjunctival space and spread throughout with external pressure applied with a cotton tip applicator. Eyes were observed for six months. A similar procedure was performed on live mice and rabbits. Attention was paid to the appearance, homogeneity, longevity and tolerance of the ink. Lastly the procedure was performed on a human subject. Attention was directed to possible side effects. All live eyes were given postoperative topical antibiotics.
Results:
All cadaver eyes accommodated the ink in the subconjunctival space. The ink could be easily spread throughout the eye in a homogeneous fashion. The ink remained visibly apparent throughout the study period of six months. Live animal models demonstrated that the ink was tolerated by the eye with no signs of inflammation. The ink would cover up the deeper scleral vessels but the superficial conjunctival vessels were still visible. The effect of the procedure remained during the entire study period of six months. The human subject reported mild transient tearing, light sensitivity and seepage of ink during the first five days but it quickly abated after that time period. Visual acuity, intraocular pressure, cell and flare, lack of corneal staining, and lid position were unchanged throughout the study period. The appearance of the human eyes post operatively was consistent for 24 months.
Conclusions:
This cadaveric, live animal and human study demonstrates the possibility of utilizing subconjunctival injections as a means to whiten eye appearance and avoid the risks associated with previously used techniques.