Results of Keratopigmentation with a Novel Technique Using a Microneedling Device: Dermapen

PURPOSE: We aimed to evaluate safety, indications, and patient satisfaction for keratopigmentation (KTP) with microneedling in patients with corneal leukoma. MATERIALS AND METHODS: This retrospective study included patients who underwent KTP using a microneedling device (Dermapen) between January 2020 and May 2025. A total of 11 eyes from 11 patients with corneal leukoma were included. KTP was performed under sterile conditions and topical anesthesia, using the Dr. Pen Ultima N2-W Dermapen device. Sterile skin tattoo pigments, selected to match the color of the fellow eye, and approved by the European Union REACH (Registration, Evaluation, Authorization, and Restriction of Chemicals) were used, without dilution. RESULTS: The underlying causes of corneal leukoma included trauma in four cases, keratoplasty rejection in three cases, bullous keratopathy in one case, Peters anomaly in one case, congenital glaucoma in one case, and phthisis secondary to glaucoma in one case. The mean procedure time in all patients was calculated as 35.6 ± 12.3 minutes. Corneal epithelium healed and conjunctival hyperemia resolved within 1 week in all patients. The mean follow-up period was 17.06 ± 7.3 months (8-39 months). All patients demonstrated aesthetic improvement in ocular appearance postoperatively. No significant pigment fading or migration (>10% surface area) occurred, and cosmetic outcomes remained stable without need for repeat pigmentation. No additional surgical intervention or repigmentation was required. CONCLUSIONS: Dermapen is a device that offers a practical and homogeneous method for corneal KTP. The ability to adjust the needle depth allows for a personalized treatment approach.