It’s crucial to distinguish between a trained eye surgeon performing a functional cosmetic procedure, which is not only ethical but can be life-changing, from a tattoo artist risking a person’s vision, which should be illegal.
I am one of the only ophthalmologists in the country performing eye tattoos. However, after completing a residency at Harvard to learn how to perform common types of eye surgery such as cataract surgery, I then completed a fellowship at Emory to learn how to perform corneal transplants, LASIK/LASEK, and corneal tattoos. My Fellowship Director was Doyle Stulting, MD, PhD, Past President of ASCRS, and one of the most famous corneal surgeons in the world–he was the one who taught me how to perform a corneal tattoo as a sterile, microsurgical procedure.
Since 1997, I have performed approximately 20 corneal tattoos, compared to 20,000 LASIK & LASEK procedures. This means the procedure is very rare, and only useful in a limited number of cases. However, like performing a LASEK in patients with extreme prescriptions over -10.00, corneal tattoos can be life-changing.
Last year, I performed a corneal tattoo on a man who works for the Knicks at Madison Square Garden as a security guard. He had a knife injury as a child 40 years ago, went blind, and had a very dense, cosmetically unacceptable scar–basically, his right eye was essentially white. I debrided the scar manually with a blunt blade, further removed some scar with a chemical, EDTA, to dissolve the calcium component of the scar, and then performed the corneal tattoo using a specially-modified machine. This tattoo machine has a tight cluster of only 3 needles, to give me fine control. A regular machine might have as many as a dozen needles, to cover large areas of skin quickly. We adjusted the travel of these needles to be only 1 mm, since the entire cornea is only 0.5 mm thick, to prevent perforating the eye–when tattooing the dermis, the tattoo artist has to penetrate at least 1 mm, which would perforate the eye. Our machine can go down to a repetition rate of 3 Hz, meaning 3 strokes of ink application every second, in comparison to someone tattooing someone’s arm, where they might set a less precisely controllable machine at 30 Hz–meaning 30 applications of ink per second (again, so they can cover large areas quickly). We even ordered special ink that is centrifuged to retain only the smallest particle sizes–all to give me, the eye surgeon, the finest control possible.
The unsafe method used to tattoo the sclera is to inject ink underneath the conjunctiva, or the clear tissue covering the entire eyeball, in an attempt to dye the underlying white part of the eye. The reason this method is unsafe, and should be illegal, is it requires a vast amount of ink–perhaps as much as 10 mL–and is inherently uncontrollable. That vast quantity of ink is which caused the severe allergic reaction in that model–although reports that she “went blind” are clearly incorrect, as after a few months (or a few days, if she had received proper immediate care, which would be an injection of steroid, also underneath the conjunctiva) the inflammation would resolve and her vision should return
Rarely, I have also tattooed the sclera, but again this is using a very precise, microsurgical technique, under sterile conditions–not by injecting a dye underneath the conjunctiva and not being able to control its dispersion at all.
In summary, there are less than 10 eye MDs in the US who have been specially trained to perform eye tattoos. I am saying 10 as an estimate, because I know of only 2–myself and Dr. Stulting. Using the proper technique, under sterile conditions, and by a Board Certified ophthalmologist, this technique has been proven over the past 30 years to be both safe & effective.
On the other hand, I think that anyone who goes to a tattoo artist for an eye tattoo must be uninformed to make such a careless decision. Hopefully by making the public aware of the clear distinction between eye surgeons and tattoo artists in terms of the vast differences in their training and technique, any interested parties will choose more wisely, to avoid such preventable ophthalmic misadventures.
Emil William Chynn, MD, MBA is owner of Park Avenue Laser, a subspecialty referral practice in New York, NY.
Dr. Chynn has made a habit out of treating cases that no one else can. Not only has he safely lasered the highest prescription ever in the world (-24.00 — the upper limit for LASIK is -9.00), he is also one of a handful of surgeons in the world trained in the proper technique of tattooing someone’s eyeball!
Dr. Chynn has consistently been at the forefront of ophthalmic techniques having trademarked his 100% Non-Cutting, SafeSight™ technique, which is 10x safer than LASIK, so safe that it’s actually safer than contacts. LASEK can even fix problems caused by LASIK–such as night glare or halos!
Dr. Chynn’s incredible successes have led him to be featured on a range of different media outlets such as The New York Times, CBS, and CNN. In fact, the last corneal tattoo Dr. Chynn performed (not live) was featured on Discovery Channel to an audience of millions. It was this piece on Discovery Channel that led Winston to seek Dr. Chynn’s help.
Winston has had a long and complicated history of eye problems and had cataract surgery performed back in 1983, followed by having a lens implanted in his cornea which damaged the cornea. Winston even had a corneal transplant performed in 1997. Unfortunately, the corneal transplant “failed” so now he has a totally white cornea that looks bad, and is cosmetically unacceptable.
He told Dr. Chynn, “I know nobody can make me see better out of that eye, and thank God it doesn’t matter so much since I’m seeing well out of my other eye. If only I could look more normal, I would feel better about myself, be able to look someone ‘in the eye’ and be a new, more confident person!”
Dr. Chynn previously performed a corneal tattoo for Mr. Ralph Lauren’s limo driver, who had an injury that left him with one eye that “looked like a cue ball” (his words). After his corneal tattoo, he said, “I thought the most dramatic difference would be in my work, as clearly people get ‘wigged out’ if their limo driver has one good eye. But the best thing is my daughter said, “Now I can invite my friends over to play, as before they would say mean things about you, and I would fight, and get into trouble for that.”
In order to ensure the best possible results, Dr. Chynn has coordinated with the top tattoo equipment manufacturer in NYC, to choose the highest-end, best tattoo machine, and a top tattoo artist to help him color-match the ink to exactly match the patient’s other iris color.