Keratography

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With Keratography (also: corneal tattooing ) is called an in ophthalmology applied, refined form of tattoo and a rarely practiced method of reconstructive surgery .

Process and areas of application

In keratography, color-fast pigments ( platinum chloride ) are introduced into the middle layer of the cornea (stroma) of the eye . In appropriately indicated cases, an operation is usually only carried out on eyes that show irreparable damage from accident or illness and whose visual acuity has already been lost. It is hoped that this will improve the external appearance of the iris and pupil and possibly a cosmetic reconstruction of the eye. In some cases, tattoos on the cornea may be based on other medical indications, for example in the case of pronounced forms of albinism , aniridia , iris coloboma , keratoconus and, in particular, whitish, large-area corneal scars (leukoma, leucoma corneae , also leucoma adhaerens ). In cases where there is still some residual vision or poor visual acuity, this may reduce the annoying glare effects . A stenopic effect, which can lead to a certain improvement in visual acuity , can not be ruled out either .

The term keratography now shows a certain ambiguity , since video keratography , a measurement method for corneal topography ( keratometry ), is often also called keratography for short.

Risks and Disadvantages

Despite the possible advantages for a small group of patients, the procedure of keratography is associated with considerable risks, not least because of the difficulty of the procedure and the lack of precise feasibility. Some patients complain of foreign body sensations after treatment. Not all people treated respond equally to the procedure, the color can evaporate after a while, the size of the tattoo can change, or the procedure leads to keratitis . Toxic reactions, permanent corneal epithelial defects, corneal ulcer or iridocyclitis are also known to be possible complications. Overall, the treatment results of keratography are not always satisfactory.

history

A treatment intended to hide disfiguring scars or injuries to the anterior segments of the eye has been known for about 2000 years. It was first mentioned in 150 AD by the Greek doctor Galenos , but was later forgotten again. The French ophthalmologist Louis de Wecker later modified the procedure and re-introduced it around 1869.

After the corneal tattoo was hardly used for decades with the development of improved surgical methods, today it can again represent an adequate treatment method for plastic correction and aesthetic improvement of the anterior eye segments, at least for a limited number of patients.

See also

Individual evidence

  1. ^ V. Klauß, EM van der Velden, B. Drost, S. Weede, U. Schaller: Keratography (corneal tattoo) in corneal leukoma. Lecture at the 97th annual conference of the DOG 1999.
  2. Ji-Eun Lee, Jong Bae Jun, Hee Young Choi, Boo Sup Oum, Jong Soo Lee: Corneal tattooing to mask subsequent opacification after amniotic membrane grafting for stromal corneal ulcer. In: Acta Ophthalmologica Scandinavica. Vol. 84, No. 5, June 2006, ISSN  1395-3907 , pp. 696-698, doi : 10.1111 / j.1600-0420.2006.00680.x .
  3. E. Wenzl, N. Ardjomand: Corneal tattoo with anterior lamellar keratoplasty. In: Spectrum of Ophthalmology. Vol. 24, No. 4, August 2010, ISSN  0930-4282 , pp. 234-236, doi : 10.1007 / S00717-010-0421-y .
  4. Christoph Zink, Willibald Pschyrembel , Otto Dornblüth : Pschyrembel Clinical Dictionary. 255th edition. Walter de Gruyter, 1986, ISBN 3-11-007916-X , pp. 954 f. ( Leukoma ).
  5. ^ UC Schaller, EM van der Velden, BHIM Drost, S. Weede, V. Klauß: Keratography (corneal tattoo ) in corneal leukoma . In: The ophthalmologist. Vol. 98, No. 2, February 2001, ISSN  0941-293X , pp. 147-150, doi : 10.1007 / s003470170175 .
  6. Snejina Vassileva, Evgeniya Hristakieva: Medical applications of tattooing. In: Clinics in Dermatology . Vol. 25, No. 4, July / August 2007, ISSN  0738-081X , pp. 367-374, doi : 10.1016 / j.clindermatol.2007.05.014 , PMID 17697919 , (Review).
  7. ^ S. Lewis Ziegler: Multicolor Tattooing of the Cornea. In: Transactions of the American Ophthalmological Society. Vol. 20, 1922, ISSN  0065-9533 , pp. 71-87, PMID 16692612 , PMC 1318311 (free full text).
  8. a b c Susanne Pitz, Robert Jahn, Lars Frisch, Armin Duis, Norbert Pfeiffer: Cornea tattoo. Today's importance of a historical treatment method. In: The ophthalmologist . Vol. 97, No. 2, February 2000, pp. 147-151, doi : 10.1007 / s003470050025 .
  9. ^ JN Roy: Tattooing of the Cornea. In: The Canadian Medical Association Journal. Vol. 39, No. 5, November 1938, ISSN  0820-5930 , pp. 436-438, PMC 536811 (free full text).
  10. Jamshedji N. Duggan, BP Nanavati: Tattooing of Corneal Opacity with Gold and Platinum Chloride. In: British Journal of Ophthalmology. Vol. 20, No. 7, July 1936, ISSN  0007-1161 , pp. 419-425, PMC 1142682 (free full text).
  11. James H. Doggart: Significance of Color Change in the Cornea. In: British Journal of Ophthalmology. Vol. 43, No. 1, January 1959, pp. 13-20, PMC 512203 (free full text).
  12. A. Sharma, P. Gupta, Mangat R. Dogra, Ahmed A. Hidayat, A. Gupta: Granulomatous Keratitis following Corneal Tattooing. In: Indian Journal of Ophthalmology. Vol. 51, No. 3, July / September 2003, ISSN  0301-4738 , pp. 265-267, PMID 14601857 .
  13. Susanne Pitz, Robert Jahn, Lars Frisch, Armin Duis, Norbert Pfeiffer: Corneal tattooing: an alternative treatment for disfiguring corneal scars. In: The British journal of Ophthalmology. Vol. 86, No. 4, April 2002, pp. 397-399, PMID 11914207 , PMC 1771069 (free full text).