What is Keratopigmentation?

Keratopigmentation (KTP) is a surgical procedure used to correct cosmetic and therapeutic issues in the eye. This procedure is applied particularly to treat iris defects and corneal scarring or to change eye color. It is performed using manual or laser-assisted techniques and typically involves the placement of micronized mineral pigments into the corneal layers. Keratopigmentation performed for cosmetic enhancement and visual rehabilitation has high success rates and shows rare complications. However, possible side effects such as pigment fading and inflammatory reactions can also occur. The procedure offers aesthetic and visual benefits.

What is Keratopigmentation?

Keratopigmentation is a surgical procedure that changes the appearance of the eye for aesthetic or therapeutic purposes by placing pigment into the corneal stroma. Initially developed to conceal corneal opacities, this method is now also used for cosmetic eye color changes. Thanks to femtosecond laser technology, microtunnels are created in the cornea, allowing pigments to be placed precisely.

This technique, which was scientifically recognized in the early 2010s, continues to evolve. Although keratopigmentation does not have FDA approval for aesthetic uses, it generally yields successful results and is considered a promising method for the future in this field. It is a procedure acknowledged for delivering effective results in terms of eye health and aesthetic appearance.

How Does Keratopigmentation Work?

Keratopigmentation works by placing pigments into the stromal layers of the cornea. This procedure focuses on aesthetically altering the appearance of the eye without disrupting its natural structure or visual function. Typically, microtunnels are created on the cornea using laser-assisted methods, and pigments are placed into these tunnels. The pigments are used to change the eye’s aesthetic appearance or to conceal scarring in the cornea.

Methods used:

• Femtosecond laser
• Manual microtunnel creation techniques

When pigments are properly placed into the corneal stroma, long-lasting and safe results are achieved. After the procedure, the pigments remain in place over time, and the risk of fading is kept to a minimum. Keratopigmentation offers a permanent solution for those wanting to change their eye color while also being usable for therapeutic purposes.

When is Keratopigmentation Used?

Keratopigmentation is a procedure preferred for both therapeutic and cosmetic purposes. It is particularly used to enhance the aesthetic appearance of the eye or to manage visual impairments. It can be used to change eye color for aesthetic reasons or to correct shape irregularities in the eye. Additionally, it is applied to provide visual and cosmetic improvement following damage to critical areas of the eye, such as the iris and cornea.

Cosmetic indications:

• Corneal scars
• Corneal opacities
• Change of eye color

Therapeutic indications:

• Iris defects
• Corneal scarring
• Leukomas

Ocular reconstruction:

• Traumatic eye injuries
• Surgical complications

Keratopigmentation is an important alternative, especially in situations where invasive surgical procedures like corneal transplantation are not possible or preferred. Technological advancements, particularly the use of femtosecond lasers, have increased the accuracy of the procedure, ensuring more successful outcomes both aesthetically and therapeutically. This procedure not only corrects the cosmetic appearance of the eye but can also enhance the patient’s quality of life.

Who is Not Suitable for Keratopigmentation?

Keratopigmentation may not be a suitable option for patients with certain eye conditions. The pigments or surgical techniques used during the procedure can lead to adverse outcomes in individuals with specific eye problems. In particular, existing health conditions such as active infections or severe inflammations can jeopardize the safety of the procedure. Additionally, previous surgical interventions related to eye health can also reduce the chances of a successful outcome.

Therefore, the main conditions that are unsuitable for keratopigmentation are as follows:

• Active eye infection
• Severe ocular surface disease
• Glaucoma
• History of corneal graft
• Pigment allergy
• Severe inflammation in the eye

Individuals with such conditions should avoid keratopigmentation procedures. It is extremely important for the doctor to perform a detailed examination to determine whether the patient is suitable for the procedure concerning eye health. In this process, the patient’s overall health status should also be considered to minimize risks.

How is Keratopigmentation Performed?

Keratopigmentation is a surgical procedure performed by precisely placing pigments into the corneal stroma and is applied for both cosmetic and therapeutic purposes. During the procedure, the surface of the eye is sterilized, and anesthetic drops are used to ensure the patient’s comfort. The pigment placement process can be performed using two main methods: manual techniques and femtosecond laser-assisted methods. Both techniques allow for the safe and effective placement of pigments into the corneal layers.

Manual Method:

• Fine needles
• Spatulas
• Superficial layers
• Deep layers

Femtosecond Laser-Assisted Method:

• Femtosecond laser
• Intrastromal tunnel
• Preservation of deeper eye structures
• Controlled pigment placement

After the procedure is completed, patients are prescribed antibiotic and anti-inflammatory drops. These medications support the healing process and minimize the risk of infection. The keratopigmentation procedure is particularly preferred for patients with corneal opacities or scarring. It can also be used for individuals seeking cosmetic eye color changes. The longevity and outcome of the procedure may vary depending on the quality of the pigments used, the patient’s eye structure, and the doctor’s experience. The results generally offer a natural appearance and meet the patients’ aesthetic expectations.

What are the Side Effects of Keratopigmentation?

Keratopigmentation is a surgical procedure applied for cosmetic and therapeutic purposes, but it can lead to some side effects and complications. These effects can generally appear in the post-procedure period and may adversely affect patients’ long-term eye health. Due to the invasive nature of the procedure, risks and complications should be considered.

Possible side effects include:

• Corneal damage
• Infection
• Irregular astigmatism
• Pigment leakage
• Endothelial decompensation
• Visual field examination issues
• Pupil irregularity
• Decentration

Some of these side effects may be temporary, while others can lead to permanent damage. In particular, corneal damage and harm to endothelial cells can result in serious consequences, potentially leading to the need for additional treatments such as corneal transplantation in later stages. Additionally, infections and inflammation can cause problems that may progress to vision loss.

The keratopigmentation procedure may increase risks for individuals who have previously undergone eye surgery. For example, having this procedure after surgeries like LASIK can be dangerous. Additionally, it is a risky procedure for patients with underlying corneal diseases.

How Successful is Keratopigmentation?

Keratopigmentation (KTP) is a procedure that yields highly successful results when used for both cosmetic and therapeutic purposes. Patient satisfaction rates are generally very high, with studies showing these rates ranging between 85% and 95%. Most patients are satisfied with the aesthetic appearance of their eyes after the procedure.

Factors contributing to success rates include:

• High patient satisfaction
• Low complication rates
• Low pigment loss
• Mild side effects

In some patients, slight pigment loss may be observed over time; however, this condition can generally be corrected with minor touch-ups. Cases requiring extensive revision are rare. Among the side effects, pigment leakage or slight pigment fading are the most commonly encountered. The success of keratopigmentation is significantly influenced by the advancement of the techniques used and the surgeon’s experience. Additionally, the quality of the pigments used contributes to the preservation of aesthetic results in the long term.

How to Prepare for Keratopigmentation?

Preparation for keratopigmentation surgery requires patients to be physically and mentally ready for the operation. To achieve a good outcome, there are several important steps to be taken before the procedure. Patients can ensure a safe and successful surgery by closely following the surgeon’s instructions:

• Take a shower on the day of the surgery
• Wash your hair
• Wear clean and comfortable clothing
• Do not wear makeup
• Do not use false eyelashes
• Avoid cosmetic products on the face
• Do not wear contact lenses

Having a light meal before the surgery can prevent dizziness or nausea that may occur during the procedure. Patients should avoid very heavy foods before the operation but also ensure they do not go completely hungry. Additionally, they should be aware of the possibility of mild discomfort or blurred vision during the procedure. A short rest period is required after the surgery; therefore, patients should keep themselves away from strenuous activities throughout the day.

Keratopigmentation is generally a painless procedure, but like any surgical intervention, careful preparation is essential. A rapid recovery process is aimed for after the procedure, and it is important for patients to adhere to post-operative care instructions to ensure this process goes smoothly.

How Should Post-Keratopigmentation Care Be?

Post-keratopigmentation care plays a critical role in the successful outcome of the surgery and the prevention of complications. In this process, not only is the protection and hygiene of the eyes important, but also strictly adhering to the doctor’s recommendations is crucial. To support the healing process that begins immediately after the surgery, there are some fundamental elements that the patient should pay attention to:

• Use of prescribed eye drops
• Protection of the eyes from bright light
• Avoidance of physical strain
• Attention to eye hygiene
• Regular visits to the doctor for check-ups
• Experiencing blurred vision and mild discomfort
• Avoidance of heavy physical activities

Timely and regular use of eye drops reduces inflammation and prevents the risk of infection. Avoiding activities that strain the eyes during the first few days helps accelerate the healing process. Additionally, wearing sunglasses to protect the eyes from bright light and UV rays provides comfort to the eyes during the healing period.

Regular doctor visits are essential for the early diagnosis of possible complications that may arise after surgery. These check-ups help monitor conditions such as pigment placement or infection. If necessary, the surgeon can perform additional procedures to correct the pigments. Therefore, it is recommended that the patient meticulously adheres to this treatment process to best protect their eye health.