Stability of Iris pattern corneal tattoo using dermal ink

PurposeTo 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.MethodsA 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.ResultsFifty 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.ConclusionCorneal 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.