A novel indigenous technique for corneal tattooing using self-prepared do-it-yourself carbon soot pigment

PURPOSE: To evaluate the cosmetic efficacy and safety of an indigenous novel corneal tattooing technique using a self-prepared candle soot pigment. METHODS: This pilot observational study involved 22 eyes of patients at a Bengaluru-based ophthalmology setting. The study considered only eyes with nil or low visual potential. Eyes with active ocular inflammation, nasolacrimal obstruction, severe hypotony, and shrunken globe due to phthisis bulbi were excluded. The surgery was carried out under aseptic conditions using a self-prepared carbon soot pigment. Different methods such as lamellar, surface needle micropuncture, machine-assisted surface tattooing, or a combination were used for pigment application. RESULTS: Ten eyes underwent combined lamellar and surface tattooing; lamellar tattooing was performed for 11 eyes, and surface tattooing for one eye. Nineteen patients underwent limbus-to-limbus corneal tattooing and three patients had undergone focal tattooing to cover nasal pterygium scar, inferior iridectomy, and leukocoria due to calcific cataract. Nearly 91% were subjectively satisfied with the tattooing technique and 82% had excellent cosmetic coverage along with subjective satisfaction. None of the subjects required a repeat surgery or augmentation of tattooing. There was no reported case of corneal inflammation, epithelial erosions, infiltrations, infections, nonhealing areas, stromal melting, or any other complications. CONCLUSION: This novel procedure, involving self-prepared carbon soot pigment tattooing, provides excellent cosmetic results and high patient satisfaction. It is relatively safe, easy to perform, and the conventional steps of tattooing such as pigment procurement, storage, and sterilization can be avoided, as the carbon pigment is freshly prepared under aseptic conditions.