Warning Coloration

Last August, The New Optometrist reported on keratopigmentation – also known as corneal tattooing – and its potential uptake in the cosmetic surgery market. The article also highlighted some documented risks that have been associated with the surgery – namely, a the patient’s adverse reaction to the pigment used, as well as the potential for microbial infection and corneal perforation – and concerns by some medical professionals, indicating that the cosmetic intervention can potentially obscure ocular pathology, making it harder for eye care professionals to diagnose corneal disturbances.

Last month, The American Academy of Ophthalmology (AAO) issued a public warning against keratopigmentation and iris implant surgery for cosmetic purposes. The warning seems to have been made in response to a TikTok video of the procedure that went viral, gaining over 24.5m views since it was posted on December 28, 2023. “While every ocular surgery has inherent risks, those that are not carefully studied may carry even greater risks, especially when performed purely for cosmetic reasons on otherwise healthy eyes,” says AAOs JoAnn A. Giaconi. “All patients should be fully informed of the risks, benefits, and alternatives before deciding on one of these procedures.”

The Academy acknowledges that – though the risks of implanting an artificial iris can be outweighed by the benefits in those patients requiring the implant for medical reasons – these same risks, including corneal injury, cataracts, and reduced vision or blindness, are simply not worth it for purely cosmetic reasons. They also reiterated the risks that keratopigmentation can pose to those undergoing the procedure, as well as post-surgical risks such as photophobia, uveitis, and leakage of the color pigment into the rest of the eye.   

“[For] those who feel strongly about changing their eye color, these procedures are not the only options available,” says Giaconi. “The safest way to change your eye color is a less permanent option: color contact lenses,” adding, of course, that color lenses should not be bought online or over-the-counter without a prescription.