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Five-year Results of Corneal Tattooing for Cosmetic Repair in Disfigured Eyes

Purpose: To investigate the 5-year results of corneal tattooing for cosmetic repair in disfigured eyes and identify the risk factors associated with complications. Methods: Corneal tattooing was performed in patients with stable corneal opacity and blind eyes. A total of 147 eyes of 147 patients who were followed up for at least 5 years after tattooing were enrolled in the study. The following valuables were included as potential risk factors for long-term complications: age, sex, duration of opacity before tattooing, and the presence of calcific plaque. Corneal tattooing was also performed in 6 rabbit eyes, and the stained eyes were enucleated at 6 months postoperatively for histological analysis. Results: The average follow-up time after surgery was 65 ± 5 months. Long-term complications such as reopacification or increased opacity, fading of color, and epithelial growth developed in 12% of the tattooed eyes between 2 and 4 years after surgery and most required reoperation. Univariate analysis of risk factors affecting recurrence or complications revealed no statistically significant differences among candidate factors. Histological results of the tattooed rabbit eyes showed that clumps of blackish granules were present in the anterior half of the stroma without any infiltration of inflammatory cells to the adjacent layers. Conclusions: Corneal tattooing in disfigured eyes provided a good cosmetic outcome more than 5 years after surgery.