Eye color change surgery is used to change the colored part of the eye, called the iris, after an injury or other medical condition affecting the eye. Less commonly, it is used for cosmetic reasons as a permanent alternative to colored contact lenses.
There are three procedures that can be used to change your color:
- Laser keratopigmentation: Also known as "corneal tattooing," this uses a laser to precisely deliver a dye into the clear dome in the front of your eye, called the cornea.
- Laser depigmentation: This also uses lasers to strip away pigment-producing cells on the top layer of the iris, called melanocytes.
- Iris implant surgery: This involves the replacement of your natural iris with a prosthetic (artificial) iris.
While colored contact lenses are the safest solution for eye color change, surgery may be appropriate if a damaged or abnormally colored iris is causing you distress. Even so, the procedure may not be covered by insurance.
The article describes the different eye color change surgeries, including their costs, risks, and recovery times.
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Can You Permanently Change Your Eye Color?
The color of your eye can be permanently changed. It can be done by adding or extracting pigments or replacing the entire iris.
Eye color change surgery is generally an elective procedure since the color of the iris has no effect on vision. With that said, if an eye injury or disease causes a color change, it may be a necessary part of reconstructive surgery.
Eye color change is sometimes used as an "add-on" to a prescribed procedure like cataract surgery, lens implant, or corneal transplant.
Less commonly, eye color change surgery is used for purely aesthetic reasons and comes with considerable risks.
Laser Keratopigmentation
Laser keratopigmentation is also known as "corneal tattooing." It doesn't change the color of the iris but instead adds color to the cornea to conceal the color of the iris.
Keratopigmentation uses lasers to create a series ofcircular tunnelsof uniform depth in the cornea. A color dye is then injected into the tunnels. The use of robotic lasers ensures a more even color distribution than older "needle-puncture" techniques.
Keratopigmentation is done with anesthetic eye drops to numb the eyes. Your head will be strapped into a harness to keep it still, and a caliper-like device will hold your eyelid open and prevent blinking. The procedure may be uncomfortable but causes little, if any, pain.
Risks
Despite the accuracy of this technique, keratopigmentation is not without risks. While every effort is made to stabilize the eye and head, any inadvertent movement can lead to errors and possible injury. Other complications can arise after the procedure.
Possible risks of laser keratinization include:
- Inconsistent eye color: Caused by the uneven distribution of the dye
- Color fading: Due to the migration of the dye or the leakage of dye into the corneal space
- Corneal perforation: A puncture of the cornea that can lead to fluid leakage, vision changes, and the "sinking" of the corneal dome
- Light sensitivity: Caused by the abnormal refraction of light as it bounces off the opaque edges of the treated cornea
- Reaction to the dye: Leading to uveitis (inflammation of the middle layer of your eye) or corneal neovascularization (the formation of new blood vessels in the cornea)
- Bacterial eye infection: Which increases the risk of corneal ulcers and scarring
Laser keratopigmentation is contraindicated for people with corneal diseases or those who have had refractive eye surgery like LASIK.
Cost
The cost of keratopigmentation can vary by the provider and type of equipment used, but a casual review of providers suggests that costs start at roughly $10,000 for both eyes.
Keratopigmentation is performed by a licensed ophthalmologist. It is not covered by insurance because it is an elective cosmetic procedure and not a medical necessity.
Recovery
Keratopigmentation has a relatively short recovery time because the corneal surface is untouched and the dye is contained within the corneal tunnels.
Most people can function normally within two to three days. Full recovery and healing can take anywhere from one to three weeks. Expect minor discomfort on the first day, followed by sensitivity to bright lights for up to three days.
Laser Depigmentation
While laser keratopigmentation is an additive procedure, laser depigmentation is a subtractive procedure.
Laser depigmentation (also known as photoablative iridosplasty) is used to lighten eye color by targeting cells that produce melanin (the pigment that gives skin, hair, and eyes their color). Dark eye colors are the result of high melanin production, while light colors are the result of low melanin production.
Laser depigmentation is performed over a series of sessions. Low-energy laser beams heat the brown pigment on the surface of the iris and reveal the blue or green color underneath. The laser beams pass through the cornea without causing any injury.
The procedure, performed with anesthetic eyedrops, is said to be painless.
Risks
Compared to the other eye color change techniques, laser depigmentation appears to be less problematic. Risks include:
- Iritis: Inflammation of the iris (usually mild and short-lived)
- Light sensitivity: Caused by the abnormal dilation of the pupils (usually short-lived)
- Unwanted eye color: The underlying green or blue color can only be revealed once the overlying brown layer is removed,
Laser depigmentation is contraindicated in people with glaucoma.
Cost
Laser depigmentation costs somewhat less than other eye color change procedures because it doesn't involve any cutting of tissues. Prices can vary greatly by providers, ranging from $5,000 to $7,000 or more for both eyes.
Laser depigmentation is performed by a licensed ophthalmologist and is not covered by insurance.
Recovery
The change in eye color with laser depigmentation is not immediate. It can take up to four weeks for the body to reabsorb the brown layer and fully reveal the underlying blue or green color.
There may be mild blurring, red eye, tearing, and light sensitivity an hour or two after the procedure. If iritis occurs, it tends to be brief, causing headaches, abnormal pupils, and light sensitivity.
Iris Implant Surgery
Iris implant surgery is a more invasive procedure that involves the insertion of a prosthetic iris to cover the natural iris. It is performed as an outpatient procedure using a local anesthetic.
The technique was first developed in 1956 to repair iris defects caused by an injury, infection, or congenital defects like ocular albinism. It is less commonly used for cosmetic purposes due to the possible risks.
Most iris implants are available in stock colors such as blue, green, brown, and black. People who desire color change in one eye may order customized iris to match the other eye.
To implant the iris, the ophthalmologist makes a small incision in the cornea where it meets the sclera 405 (white of the eye). The silicone iris is folded and inserted through the incision. The prosthetic is then unfolded and sutured into position over the natural iris.
Risks
The risks of iris implant surgery are significant and sometimes severe, making them a less attractive option for people seeking an eye color change.
Some of the most serious complications include:
- Glaucoma: A progressive condition affecting the optic nerve
- Cataracts: Clouding of the eye lens
- Eye infection: Leading to corneal ulcers and scarring
- Reduced vision or blindness
Iris implants are contraindicated in people with glaucoma and diabetic retinopathy.
Expert Consensus
The American Academy of Ophthalmology, American Glaucoma Society, and the Contact Lens Association of Ophthalmologists strongly discourage people from undergoing cosmetic iris implant surgery due to the potential damage it may cause to healthy eyes.
Cost
Iris implant surgery is not approved by the FDA for any reason other than to treat a medical condition. There are practitioners overseas who will perform the procedure at costs well in excess of $10,000. not including travel costs.
Recovery
For the first 24 to 48 hours after iris implant surgery, your eye may feel slightly gritty or scratchy, and your eyes may be teary and sensitive to light. It is not uncommon for your vision to remain slightly blurry for the first week or so.
A protective eye patch may be needed to prevent you from touching or scratching the eye while you sleep. Recovery time can range anywhere fromtwo to eight weeks.
Temporarily Changing Your Eye Color
If you are seeking to change your eye color for cosmetic reasons, there are temporary options that allow you to do so on demand.
Colored contact lenses are the easiest option. Available in both prescription and plain lenses, there are several types to choose from:
- Opaque lenses: These contacts are non-transparent and best for people with dark eyes who want a lighter shade.
- Enhancement lenses: These are transparent and help enhance the natural color of your eyes.
- Visibility lenses: These have flecks of light blue or green that accentuate the iris and make it seem more vivid.
If you wear eye makeup, you can also accentuate your eye color by framing them with different eye shadows. Dark eyes often seem brighter with cooler, lighter-colored eye shadows, while blue eyes may seem more intense with warmer, darker-colored eye shadows.
Can Eye Color Change Over Time?
Eye colors will usually remain the same as a person's entire life. For some, melanin levels can change as they get older and make their eyes seem lighter. This is harmless and nothing to be worried about.
However, there are several medical conditions that can cause your eye color to change spontaneously. These include:
- Fuchs uveitis syndrome: A rare condition that causes vision problems and changes to the iris
- Pigment dispersion syndrome: A rare condition in which pigment from the iris falls away and clogs the eye's drainage system
- Horner's syndrome: A common complication of a stroke that causes a smaller pupil, drooping eyelid, and changes in eye color on the affected side of the face
- Eye trauma: Causing tissue loss on the iris and a lighter eye color
If you notice the color of one or both your eyes has suddenly started to change, see an ophthalmologist as this may be a sign of a serious medical condition.
Summary
There are several procedures that can permanently change your eye color.
Laser keratopigmentation "tattoos" the cornea to conceal the underlying iris, Laser depigmentation removes pigment-producing cells covering the iris to reveal the blue or green color underneath. Iris implant surgery covers your natural iris with a soft silicone prosthetic.
All of these procedures carry possible risks, some of which may be serious. None are FDA-approved for cosmetic purposes.
