This week’s blog on The Risks Involved in Permanently Changing the Eyes Colour has been contributed by Dr Osama Giledi, Consultant Ophthalmologist, Specialist in Cataract, Cornea and Refractive Vision Correction Surgery

Eyesight or eye colour?

Artificial iris anterior chamber implants were originally developed for therapeutic purposes but have been used more recently for the cosmetic alteration of eye colour. Initially this was done in Panama in Central America but now they are also inserted in some African and Asian countries. However, there is now growing evidence about the risks and associated problems of using these implants for cosmetic effect.
Cosmetic intraocular implant is when a colour implant is placed in the anterior (front) chamber of the eye to change the appearance of the iris for cosmetic reasons. The iris is the part of the eye responsible for controlling the diameter and size of the pupil and so how much light reaches the retina at the back of the eye. The iris is coated with the pigment melanin and this is what determines the colour of the eye.
Ophthalmologists use clinically proven functional colour implants for patients with iris abnormalities as a form of treatment to improve the vision and appearance of the patient. Cosmetic implants are used purely to change the colour of the healthy iris just to suit the preference of the patient. People who do want to alter their eye colour for some reason should use daily coloured contact lenses (but with care) and should not put themselves at risk from these cosmetic anterior chamber implants.
In addition to the normal risks of any eye procedure, such as infection or inflammation, these cosmetic colour implants inserted in healthy eyes must be positioned in front of the natural iris and lens, which tends to raise the intra-ocular pressure in the eye (glaucoma), and corneal damage and lens opacity (cataract). There is also the risk of iris atrophy, irregular pupil and inflammation of the eye (uveitis).
The risks are real and I have personally seen some cases in which patients had undergone the procedure in the region and then had a problem with them, leading to some loss of vision and the need to have the implant removed through another surgical procedure. Some patients may suffer permanent damage to the eye with these implants and a poor cosmetic appearance, which was the initial reason for the procedure.
There are now many reports around the world about serious problems from using these implants and almost all the major ophthalmic societies – for example, The American Society of Cataract and Refractive Surgery (ASCRS), The European Society of Cataract and Refractive Surgeons (ESCRS), The Asia-Pacific Association of Cataract & Refractive Surgeons (APACRS) – and other professional bodies advise against the use of this cosmetic iris implant in a healthy eye. The procedure is not licenced in the USA or Europe. There are no professional clinical trials underway to study the safety or efficacy of these implants for cosmetic use and medical publications only describe their potentially devastating complications.
There is no question about the use of approved functional colour implants for patients who need them for medical reasons but with cosmetic implants, there is the risk of potentially severe and irreversible complications and even the loss of vision. These complications develop slowly over months and even years after the cosmetic iris implantation, so a patient may not feel any change or be aware of any damage to the eye, until it is too late.
As a health professional, I believe it is essential to educate patients on the risks and dangers associated with these unapproved cosmetic implants and strongly discourage their use.

Statement from the American Academy of Ophthalmology (October 2014):
Following recent media reports about a cosmetic iris implant surgery to change eye color, the American Academy of Ophthalmology, the world’s largest association of eye physicians and surgeons, is warning consumers not to undergo the procedure, which has the capacity to cause serious eye damage, vision loss and blindness. Cosmetic iris implants have not been evaluated by any U.S. regulatory agency or tested for safety in clinical trials. While the implants are not approved by the U.S. Food and Drug Administration, it has been reported in the media this month that the surgery is being performed overseas.