title: Corneal Tattooing and Anterior Stromal Puncture for Treating Symptomatic Bullous Keratopathy.
abstract: OBJECTIVE
  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.
authors.affiliation: *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.
authors.forename: Hsin-Chiung
authors.initials: HC
authors.lastname: Lin
authors.forename: Yi-Lun
authors.initials: YL
authors.lastname: Wang
authors.forename: Guang-Wu
authors.initials: GW
authors.lastname: Chen
authors.forename: Chieh-Hung
authors.initials: CH
authors.lastname: Yen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002244:Carbon / Q000008:administration & dosage*; D016022:Case-Control Studies; D003316:Corneal Diseases / Q000601:surgery*; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D012189:Retrospective Studies; D013653:Tattooing / Q000379:methods*; D014792:Visual Acuity
chemical_list: C028433:chinese ink; D002244:Carbon