Abstract
AIM—To investigate the ultrastructural appearance and the deposition pattern of dye particles in long term non-metallic corneal tattooing. METHODS—Two tattooed human corneas were obtained by keratoplasty. One corneal button was fixed in Karnovsky's solution and the other in Trumps' solution. Both corneas were divided and processed for conventional light (LM) and transmission electron microscopy (TEM). Five additional formalin fixed corneas with tattoos were retrieved from paraffin for TEM. The time between tattoo and removal of the corneal button/enucleation ranged from 7 to 61 years. All seven corneas were examined using a Jeol JCXA733 microprobe for wave length dispersive analysis in order to exclude any presence of metallic salts in the tattooed area. RESULTS—Histologically, clumps of brown-blackish granules were present mainly in the mid stroma, but also in anterior and partially in the posterior half of the stroma. On TEM, numerous round and oval electron dense particles were seen in the cytoplasm of keratocytes arranged as clusters or large islands. The larger particles appeared black, while the smaller particles were grey. In well fixed tissue a unit membrane was observed around these clusters. No granules were detected in the extracellular matrix. CONCLUSIONS—Keratocytes can actively ingest and retain tattooing particles of non-metallic dyes within their cell membrane for very long periods of time. Keywords: corneas; ultrastructure; tattooing; non-metallic substances
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Figure 1 .
Example of a peripheral optical tattoo in a patient with an eccentric pupil due to iris capture after cataract extraction. (Courtesy of Dr J Jay, Tennent Institute of Ophthalmology, Glasgow.)
Figure 2 .
Case No 1. Preoperative clinical appearance of a 19 year old non-metallic corneal tattoo.
Figure 3 .
Case No 3. Histologically the highest concentrations of tattoo particles is seen in the mid-stromal layers (haematoxylin and eosin, original magnification ×40).
Figure 4 .
Case No 2. A subepithelial keratocyte with clusters of tattooing particles. The adjacent extracellular matrix is free of foreign material (TEM, magnification bar = 1 µm).
Figure 5 .
Case No 1. A keratocyte with several intracellular clusters of tattooing particles. Fragments of limiting unit membranes (arrows) are still preserved. Also note a mixture of more (black) and less (grey) electron dense granules (TEM, magnification bar = 1 µm).
Figure 6 .
Case No 2. High power of a mid stromal keratocyte with tattoo granules of different electron density. Individual clusters are surrounded by an unit membrane (arrow) (TEM, magnification bar = 1 µm).
Figure 7 .
Case No 7. Two keratocytes with numerous intracytoplasmic clusters. Unit membranes are not preserved. The extracellular space is free of tattooing granules (TEM, magnification bar = 1 µm).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
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