Eyeworld

33 EW CORNEA April 2015 That's all you need! One-size-fits-all punctum plug eliminates sizing and simplifies stocking Pre-stretched shape (on inserter) avoids dilation and facilitates insertion Expanded shape (once inserted) assures snug fit and virtually eliminates pop-out Soft collar prevents migration and provides patient comfort FCI-Ophthalmics.com 800.932.4202 Plug into FCI for Dry Eye Treatment and watch the SnugPlug insertion video. Visit PlugintoFCI.com for promotional pricing ™ Patient with an opaque cornea, before and after the tattoo procedure Source (all): Charles "Chaz" Reilly, MD Depending on how much of the cornea needs to be tattooed, sur- geons can use a 3 mm dermal punch to mark the center of the cornea to create a pupil, Dr. Reilly said, and then tattoo the remaining area of the cornea. "Take great care in obtaining accurate pachymetry prior to the procedure to ensure you won't perforate the eye with the needle," Dr. Reilly said. It is also important to use sterile ink to prevent corneal infection. The sterile India ink is held in a tuberculin syringe. Use a 27 g or 30 g needle, bevel down, to imbed the ink into the anterior stroma, he said. Because there is thinning associat- ed with many corneal scars, stab tangentially to avoid inadvertently perforating the cornea and entering the anterior chamber, Dr. Reilly said. "Go heavier than you normally would with the ink because a certain amount of it is going to wear off," Dr. Reilly said. The major complications from the procedure include infection, inflammation, pain, and inadvertent entry into the anterior chamber. A bandage contact lens with a topical antibiotic and steroid both help to minimize the pain and discomfort postoperatively, he said. "Oral pain medications are important because this can really hurt," Dr. Reilly said. "I also give them some rescue tetracaine to keep them comfortable." Future potential option An option Dr. Reilly would like to explore in the future is a procedure he calls femto-assisted cornea tattoo- ing (FACT), where the femtosecond laser is used to make a superficial corneal pocket, and the ink is inject- ed into the pocket. This procedure would enable the tattoo to last longer, he said, and possibly achieve even better cosmetic results. EW Editors' note: Dr. Reilly has no finan- cial interests related to this article. Contact information Reilly: cdreillymd@gmail.com

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