New experimental surgery alters eye color permanently; How (un)safe is it?

Many people yearn to change one thing or the other in their appearance and are willing to go to great lengths to achieve this, including undergoing procedures such as the new experimental surgery that promises to permanently change eye color.

Indeed, it’s understandable why the idea of having a different eye color does sound enticing to a lot of people, and some of them are considering a new surgery called cosmetic keratopigmentation to permanently achieve this, according to a report by Scientific American published on April 8.

Specifically, the procedure originated in small clinics in Spain and France in the 2010s and quietly entered the US in 2019, where today a handful of ophthalmologists perform it, ‘off-label’ or at their professional discretion, without the US Food and Drug Administration’s explicit approval or supervision.

However, some of their colleagues have expressed concern about the recent rise in demand for cosmetic keratopigmentation, in part because of viral social media videos, arguing that the procedure is too risky to be readily available. 

What studies of the experimental surgery have shown

Still, the proponents liken it to LASIK, a widely approved procedure for correcting visual problems. And they might be right, as early studies indicate that serious adverse effects of cosmetic keratopigmentation are rare, and practitioners market it as safe. 

For instance, a 2018 study of 204 people who had the procedure saw 29 patients with complications, 49% of them suffering light sensitivity that tended to resolve after six months, 19% having the new eye color fade or change, 4% with slight visual field limitations, and 2% with pain in MRI machines. 

A 2021 study analyzed 40 patients two and a half years after their operation, reporting similar but less frequent complications, citing advancements in technique.

On the other hand, many opponents emphasize that research is limited to small sample sizes and short follow-ups, leaving crucial questions about long-term effects. Furthermore, the FDA doesn’t regulate the pigments used in the procedure, raising the risk of contamination by bacteria or damaging materials, including certain colorant metals.

Meanwhile, back in January 2024, the American Academy of Ophthalmology (AAO), the world’s largest association of ophthalmologists, issued a warning that cosmetic keratopigmentation, as well as the older method of changing one’s eye color – the iris implantation – “carry serious risks for vision loss and complication.”

According to the warning, cosmetic keratopigmentation could inflame or damage the cornea, cause scarring from potential infection, or affect other structures of the eye through dye leaching out of its channels. For this reason, many ophthalmologists suggest people stick to colored contacts.

Meanwhile, even the proponents of cosmetic keratopigmentation would refuse to operate on people with a history of LASIK, eye inflammation, present or prior autoimmune conditions, or other conditions that might raise the risk of complications, such as, perhaps, the mysterious eye syndrome affecting astronauts in space.