ORIGINAL RESEARCH article
Front. Med.
Sec. Ophthalmology
This article is part of the Research TopicOcular Surgery and Ocular Surface Disease: A Mutual RelationshipView all 5 articles
THERAPEUTIC KERATOPIGMENTATION VIS-À-VIS IN BLIND EYES: COMPLICATIONS AND OUTCOMES IN A SERIES OF 184 EYES Alexandre Xavier da Costa André França Fontes Cal Munik Pereira Bannach Gizeli Horta de Oliveira Giovanni Garotti
Provisionally accepted
ALEXANDRE XAVIER DA COSTA1*
ANDRÉ FRANÇA FONTES CAL2
Munik Pereira Bannach3Gizeli Horta de Oliveira4Giovanni Garotti5- 1Federal University of São Paulo, São Paulo, Brazil
- 2Hospital de Olhos Hilton Rocha, Belo Horizonte, Brazil
- 3Hospital Santo Amaro, São Paulo, Brazil
- 4Centro de Excelência em Oftalmologia, Brumadinho, Brazil
- 5Universidade de Sao Paulo, São Paulo, Brazil
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Purpose: To evaluate the outcomes, complications, and patient satisfaction following therapeutic keratopigmentation Vis-à-Vis in blind eyes. Methods: This retrospective case series included 184 eyes from blind patients who underwent KTP between 2016 and 2024, using either inorganic or mixed pigments. Superficial automated, superficial manual, and intrastromal manual approaches were performed according to corneal indication. Data collected comprised demographic information, surgical techniques, pigment type, postoperative complications, re-epithelialization time, and long-term stability. Patient-reported outcomes regarding cosmetic satisfaction and quality-of-life impact were also assessed. Results: The overall median re-epithelialization time was 14 days, though delayed healing occurred in < 20% of the patients. Postoperative complications included pigment fading, infectious keratitis, photophobia and corneal melting, though most were manageable and did not compromise final cosmetic outcomes. Cases of MRI-related ocular discomfort were noted in eyes pigmented with iron oxide–based compounds but resolved without structural alterations. At final follow-up, cosmetic appearance was graded as good to excellent in 90% of cases, and 88% of patients expressed high satisfaction, reporting improved psychosocial well-being. Conclusions: Therapeutic keratopigmentation Vis-à-Vis emerges as a meaningful intervention for blind eyes, not merely restoring external harmony but also restoring dignity and quality of life. Even with a tangible risk of complications, long-term pigment stability and high satisfaction rates highlight its value as both a reconstructive and humanizing procedure in corneal surgery.
Keywords: keratopigmentation, therapeutic keratopigmentation, keratopigmentation vis-à-vis, corneal tattooing, Blind eye, cosmetic outcomes, Corneal opacities, ocular surface surgery
Received: 07 Sep 2025; Accepted: 18 Nov 2025.
Copyright: © 2025 DA COSTA, CAL, Bannach, de Oliveira and Garotti. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: ALEXANDRE XAVIER DA COSTA, dr.alexandre.x@gmail.com
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