Confocal Microscopy Study After Keratopigmentation

Abstract

Purpose: : To report the confocal microscopy findings after keratopigmentation (KTP) in 5 patients with corneal opacity or leukocoria and to study the patient's cosmetic subjective-satisfaction after this intervention.

Methods: : A retrospective study including 5 eyes in 5 patients with corneal opacities or leukocoria and less than 20/400 visual acuity underwent keratopigmentation (KTP) for cosmetic purposes. Ink was injected to the patient's cornea with a 30 G needle. During the intervention the patients were under sub-Tenon's anesthesia. After the intervention the patients were examined by confocal in vivo laser scanning microscopy at 6 months post-op. At 6 months post-op the patient's cosmetic subjective-satisfaction was measured with a visual analogue scale. Intra-op and post-op complications were recorded.

Results: : The confocal microscopy study revealed that after KTP, the ink introduced in the cornea is located in the anterior and middle stroma surrounding the stromal keratocytes. Basal epithelial cells appeared hyperreflective. Patient's cosmetic subjective-satisfaction at 6 months post-op was 9.2/10 (x SD). All the patients (5/5) would repeat the surgical intervention. One patient had a partial epithelial defect that healed 15 days after the surgery using a cosmetic contact lens.

Conclusions: : KTP in patients with corneal opacities or leukocoria and very low vision has proved to be a safe surgical procedure with great patient cosmetic subjective-satisfaction. Confocal in vivo laser scanning microscopy has helped us to understand that after KTP the ink remains in the anterior stroma surrounding the stromal keratocytes.

Keywords: cornea: stroma and keratocytes • microscopy: confocal/tunneling • cornea: storage