Evaluation of efficacy and clinical safety profile of kerato-pigmentation done with an automated tattooing machine

Corneal tattooing or keratopigmentation (KTP) is a surgical procedure used for functional and cosmetic correction of corneal scar. This study aims to evaluate the efficacy and safety profile of superficial KTP done with presterilized gamma irradiated derma ink and an automated micropuncture device - Digital PMU & MTS system.
Material and method – KTP was performed for 25 eyes of 24 patients of superficial or deep corneal opacity with no perception of light. Out of 25 eyes, 16 had corneal scar following penetrating corneal injury5 had corneal opacity following healed keratitis, 2 had post-therapeutic failed graft and one eye each of Band shaped keratopathy (BSK) with corneal opacity and corneal opacity with absolute glaucoma. Follow up was done on postoperative day 1, 5, 2week and then monthly. Patients were evaluated for intraoperative and postoperative complications, stability of dye and on a subjective scale of satisfaction (an imaginary score with totally unsatisfied as score 1, satisfied – 2, happy – 3 and extremely happy as score 4). 
Results – Intraoperative bleed was reported in 2 of the patients. Postoperative complications included nonhealing epithelial defect (12%), inconsistent colouring (20%), colour fading (16%). Secondary surgical procedure performed were temporary tarsorrhaphy (4%) and repeat KTP (16%). 44% patient graded their experience as happy, 48% as satisfactory and 8% as totally unsatisfactory.
Conclusion – Superficial automated KTP using Digital PMU & MTS system and derma ink a relatively simple procedure with no significant intraoperative or postoperative complication. The histological safety of dye and the efficacy of this system needs to be evaluated in larger number of patients.