Combined interface tattooing and fibrin glue-assisted sutureless corneal resurfacing with donor lenticule obtained from small-incision lenticule extraction for limbal dermoid

Abstract

We describe a technique of small-incision lenticule extraction (SMILE)-assisted sutureless corneal resurfacing with interface tattooing for superficial limbal dermoids. After excision at a plane minimally below surrounding normal cornea and sclera, a corneal tattoo powder is carefully applied within an inked circular outline of the intended corneal margin. Circularity and cosmesis are assessed in natural light with the microscope light off. Fibrin glue-assisted corneal resurfacing is performed with the lenticule. The conjunctiva is closed with glue. The technique was performed in 3 patients, who had satisfactory cosmetic and refractive effects and decreased corneal astigmatism (follow-up 12 to 25 months). The technique is safe, effective, and fast with good cosmetic and refractive effects. It retains tectonic stability and decreases the risk for complications such as intraoperative perforation, postoperative limbal ectasia, and visible corneal scarring. A similar technique with a microkeratome-created thin flap on a donor cornea was alternatively performed by us in the absence of donor lenticules.