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Corneal Tattooing with Amniotic Membrane

Corneal Tattooing with Amniotic Membrane. Woo Chan Park M.D., Won Yeol Ryu M.D. Dept. of Ophthalmology, College of Medicine, Dong-A University Busan, Korea The authors have no financial interest in the subject matter of this poster. PURPOSE .

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Corneal Tattooing with Amniotic Membrane

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  1. Corneal Tattooing with Amniotic Membrane Woo Chan Park M.D., Won Yeol Ryu M.D. Dept. of Ophthalmology, College of Medicine, Dong-A University Busan, Korea The authors have no financial interest in the subject matter of this poster.

  2. PURPOSE • The purpose of this study was to investigate the effects of Davidson Marking Dye tattooing with permanent amniotic membrane transplantation (AMT) on treatment of corneal opacity and/or bullous keratopathy in patients who suffered from pain, photophobia and cosmetic problem.

  3. METHODS • We performed corneal tattooing with amniotic membrane transplantation in 27 eyes with corneal opacity and/or bullous keratopathy in patients who suffered cosmetic problem, pain, poor visual potential, photophobia from January 2002 to July 2009. • The average age of the study group was 57.7 years old (M:F=16:11) and the average follow-up period was 7.6 months (2~26 months)(Table 1).

  4. METHODS • Under the topical anesthesia, corneal epithelium was removed using No. 15 blade (Fig. 1-A) and the Davidson marking dye was applied on the cornea. We performed multiple punctures with 23G needle into the anterior stroma (Fig. 1-B,C). • The amniotic membrane was designed smaller than epithelial debridement diameter (Fig. 1-D) and was placed on the cornea and was sutured purse-string manner with 10-0 nylon (Fig. 1-E,F). • Therapeutic soft lens was worn and pressure patch was done. • Postoperatively, we assessed the resolution of pain and photophobia, and the persistence of the dye tattooing.

  5. B A C E F D Fig. 1. Procedure of tattooing and amniotic membrane transplantation (AMT) (A~F)

  6. RESULTS • Postoperative pain relief was obtained in 25 eyes out of 27 eyes (92.6%), and the photophobia was improved in 24 eyes of 27 eyes (96%) (Table 2). • The dye was disappeared more than 50% in only 2 eyes (Fig. 2~5). • In 1 eye (case 11), evisceration was carried out due to ocular hypertension. And in another 1 eye (case 22), permanent amniotic membrane transplantation was performed due to persistent corneal epithelial defect. • Postoperative visual acuity was similar to the preoperation.

  7. B A B A Fig. 2. Case 5. Ectopic pupil Partial dye-AMT was done. A. POD 1 day B. POD 6 months, dye was still remained Fig. 3. Case 16. Traumatic aniridia Hole dye-AMT & pupilloplasty were done. A, POD 3 months B. stained with fluororescein

  8. A B C D Fig. 4. Case 14. Bullous keratopathy Hole dye-AMT was done. A. POD 1 day, B. POD 5 days, C. POD 1 week, reepithelialization was done D. POD 14 months, dye was nearly disappeared

  9. B A D C Fig. 5. Case 21. Herpetic keratitis with persistent corneal epithelial defect Dye-AMT was done. A. POD 3 days B. POD 1 week C. POD 2 months D. POD 8 months, dye was still remained

  10. CONCLUSIONS The combined operation of corneal tattooing and amniotic membrane transplantation is a good choice for treatment of corneal opacity and/or bullous keratopathy with regard to cosmetic problem, pain, and photophobia.

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