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Keratopigmentation with micronised mineral pigments: complications and outcomes in a series of 234 eyes
  1. Jorge L Alio1,
  2. Olena Al-Shymali2,3,
  3. Maria A Amesty4,
  4. Alejandra E Rodriguez2
  1. 1 Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain
  2. 2 Department of Cornea and Refractive Surgery, VISSUM Corporation, Alicante, Spain
  3. 3 Department of Research & Development, VISSUM Corporation, Alicante, Spain
  4. 4 Department of Ocular Plastic Reconstructive, Lacrimal and Orbital Surgery, VISSUM Corporation, Alicante, Spain
  1. Correspondence to Professor Jorge L Alio, VISSUM, Calle Cabañal, 1, 03016 Alicante, Spain; jlalio{at}


Aim To report the complications observed in a consecutive large series of cases treated with keratopigmentation (KTP).

Methods KTP was performed in 234 eyes of 204 patients for therapeutic and cosmetic reasons. From them, 50 eyes of 29 patients suffered complications. Different KTP techniques and three generations of pigments (GP) were used. The follow-up period ranged from 4 months to 12 years. Light sensitivity (LS), visual field (VF) limitations and MRI alterations were considered functional complications. Organic complications were described as change in colour, colour fading and neovascularisation.

Results The percentage of complications was 12.82%. Most patients complained of LS (49%), then colour fading and change in colour (19%). Neovascularisation, VF limitations and MRI complications constituted 7%, 4% and 2%, respectively. Organic complications were observed with the previous GP but resolved with the latest third GP with CE mark certification (Conformité Européene). Although LS remained with the corneal-specific pigments, it gradually disappeared in most of the patients (81.81%) 6 months postoperatively.

Conclusion To the best of our knowledge this is the first time a study systematically and comprehensively approaches and reports KTP complications. KTP with third GP provides better results and fewer complications than previous ones. It is a modern, minimally invasive technique that helps solve several functional ocular problems and improves cosmetic appearance of the patients. Dermatological pigments should not be used as they lead to complications; instead pigments specifically tested for the eye in terms of toxicity and teratogenicity should be used.

  • keratopigmentation
  • organic complications
  • functional complications
  • corneal tattooing
  • pigments

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  • Contributors All authors were actively involved with: planning of the study, data acquisition, analysis and writing and revising the drafts and the final version of the paper. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Vissum Alicante Spain.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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