Stability of Iris pattern corneal tattoo using dermal ink

Abstract

Purpose

To assess the long-term stability of the color and pattern of corneal tattooing by dermal ink, designed to mimic the iris of the normal eye.

Methods

A retrospective study was performed, recruiting cases with minimum follow-up of 10 years. Patients were examined and subjected to a questionnaire assessing satisfaction. The initial procedure was selected for patients with disfiguring corneal opacity with no hope for vision and a normal fellow eye. The punctures were performed by passing a spatulated needle tip through a drop of colored dermal ink on the corneal surface, targeting the superficial one-third of the cornea. When indicated, re-shaping of corneal contour was performed to improve the angle of exotropia or normalize the corneal diameter in microcornea and macrocornea.

Results

Fifty patients were enrolled; 24 males (48%) and 26 females (52%). Mean age was 25.43 ± 13.55 years (4-62 years). Mean follow up was 10.50 ± 0.62 years. Most patients (38, 72%) needed two sessions, 6 (12%) needed one session and 6 (12%) needed 3 sessions. Thirteen cases had preoperative exotropia (XT) of 14.5 ± 3.5 PD, 11 of which (84.6%) had successful nasal shift of the corneal circumference to correct the XT. The satisfaction score was 5/5 in 42 patients (84%), 4/5 in 7 patients (14%), and 2/5 in one patient (2%). No aggressive early/late postoperative reactions were reported.

Conclusion

Corneal tattooing by micropuncture with dermal ink is a well-tolerated technique with high patient satisfaction up to 10 years after surgery. One session is generally insufficient.