Femtosecond laser-assisted annular keratopigmentation using a novel duo-tunnel technique

Keratopigmentation (KTP), or corneal tattooing, has evolved from a treatment for disfigured blind eyes to addressing functional pathologies and, more recently, cosmetic enhancement in sighted eyes. Advances in KTP now include the use of femtosecond laser-assisted intrastromal pockets, originally designed for intrastromal corneal ring segments and later adapted for pigment implantation. Various femtosecond laser platforms are used to create these precise stromal tunnels for femtosecond laser-assisted annular KTP. We introduce a novel technique using a femtosecond laser platform to join 2 adjacent small circular stromal tunnels, creating a large, unified, and consistent circular stromal pocket for pigment implantation. This method minimizes the need for manual dissection and holds promise for various clinical applications. A longer follow-up period is necessary to evaluate the potential refractive effects associated with the creation of complete 360-degree tunnels.