Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

Corneal Tattooing and Anterior Stromal Puncture for Treating Symptomatic Bullous Keratopathy

Lin, Hsin-Chiung MD; Wang, Yi-Lun MD; Chen, Guang-Wu PhD; Yen, Chieh-Hung MD

doi: 10.1097/ICO.0000000000000693
Clinical Science

Purpose: To investigate the efficacy of corneal tattooing, through anterior stromal puncture (ASP), for managing painful bullous keratopathy (BK).

Methods: This retrospective, case-controlled, consecutive case series study was performed at a university-based referral clinic. Patients with painful BK who underwent corneal tattooing with Chinese ink between 2007 and 2013 were included in analyses. Patients diagnosed with symptomatic BK who only underwent ASP during the same period were included as a control group.

Results: A total of 40 patients (27 men, 13 women) with a mean age of 57.5 ± 15.3 years were included in analyses. The clinical diagnosis was pseudophakic BK in 5 subjects (12.5%), failed graft in 11 subjects (27.5%), BK secondary to perforating corneal injury repair in 19 subjects (47.5%), and end-stage glaucoma in 5 subjects (12.5%). Subjects were followed for a mean period of 26.4 ± 7.5 months (range: 6–55 months). Recurrent bullae formation occurred in 3 of 31 patients (9.68%) who had undergone corneal tattooing and in all 9 patients (100%) who had undergone ASP (P < 0.001).

Conclusions: Corneal tattooing with Chinese ink is a simple, effective outpatient procedure for treating painful BK in eyes with no visual potential.

*Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan;

School of Medicine, Chang Gung University, Taoyuan, Taiwan; and

Department of Computer Science and Engineering, College of Engineering, Chang Gung University, Taoyuan, Taiwan.

Reprints: Hsin-Chiung Lin, MD, Department of Ophthalmology, Chang Gung Memorial Hospital, #5, Fu-Hsing St, Kweishan, Taoyuan 333, Taiwan (e-mail:

Supported by Chang Gung Memorial Hospital (No. CMRPG3C1781).

The authors have no conflicts of interest to disclose.

Received August 19, 2015

Received in revised form October 01, 2015

Accepted October 04, 2015

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.