5 Key Takeaways

• 1

  Cosmetic keratopigmentation places mineral pigment in the corneal stroma, leaving a clear central window while the iris remains untouched.

• 2

  Studies report high cosmetic satisfaction but also repeat pigment procedures, early light sensitivity, reduced contrast sensitivity, and rare corneal complications.

• 3

  Before cataract surgery, clinicians should assess the clear-window diameter relative to the dilated pupil and obtain corneal topography because ectasia has been reported.

• 4

  During cataract surgery, the pigment ring limits visualization, requiring the capsulorhexis, cortical cleanup, and lens positioning to be managed within the clear window.

• 5

  The author argues that patients should receive a record of the pigment, tunnel depth and dimensions, and procedure date to inform future eye care.