Eye Color Change Surgery: Procedures, Risks and Medical Considerations

Several surgical techniques have been used in attempts to change eye color, including artificial iris implants and corneal tattooing (keratopigmentation). Although these procedures may create the appearance of a different eye color, they involve significant structural intervention inside or on the surface of the eye. This page explains how these surgeries work, their risks, and when they may be medically appropriate—usually not for cosmetic purposes.

If you are looking for non-incisional approaches, please see our dedicated page on Laser Eye Color Change (MyLumineyes®). The information below focuses exclusively on surgical methods and why they require extreme caution.

1. What Is Eye Color Change Surgery?

Eye color change surgery refers to invasive procedures that alter the appearance of the iris either by implanting an artificial device inside the eye or by applying pigment to the cornea. These techniques were originally developed for medical indications such as aniridia, traumatic iris loss or severe iris defects—but they have sometimes been used for cosmetic purposes, which is highly controversial.

The two main surgical categories are:

• Artificial iris implants (placed inside the anterior chamber)
• Keratopigmentation / corneal tattooing (color applied within corneal layers)

Both methods carry significant risks when performed on healthy eyes with normal anatomy.

The American Academy of Ophthalmology is warning the public against two eye color-changing surgeries that are trending on social media: iris implant surgery and a laser surgery that inserts pigment into the cornea. Both of these surgeries carry serious risks for vision loss and complications.

2. Artificial Iris Implants

Artificial iris implants are silicone devices inserted into the anterior chamber of the eye to cover the natural iris. They were developed to treat specific congenital or traumatic iris defects. Cosmetic use is considered unsafe in most cases.

To learn more, see our dedicated page: Artificial Iris Implants: Risks and Complications.

How the Procedure Works

The implant is inserted through a corneal incision and positioned in front of the natural iris. This permanently changes the visible eye color but also alters the eye’s fluid dynamics, light entry and mechanical structures.

Major Risks

• Severe glaucoma due to angle blockage or pigment release
• Corneal damage (endothelial cell loss → permanent edema)
• Iritis or chronic inflammation
• Cataract formation
• Decreased visual quality or permanent vision loss

Many countries have issued warnings or bans for cosmetic use of these implants. Removal surgery is often complex and carries additional risk.

3. Keratopigmentation (Corneal Tattooing)

Keratopigmentation is a technique in which pigment is deposited into the corneal stroma to simulate a new iris color. Unlike laser or implants, this method does not modify the real iris—only the corneal surface. It may be appropriate for certain medical reconstructions but carries risks when performed for cosmetic reasons.

Detailed analysis is available here: Keratopigmentation Eye Color Change and Keratopigmentation Risks & Complications.

How the Procedure Works

Pigment is introduced into corneal layers through femtosecond-created channels or manual tunnels. The colored ring mimics an iris but does not affect the internal structures of the eye.

Potential Risks

• Corneal haze or scar formation
• Chronic irritation and foreign-body sensation
• Reduced contrast sensitivity
• Irregular light transmission → visual disturbances
• Infection risk, especially with superficial techniques

Keratopigmentation is visually permanent but may fade irregularly or require revision. Because it affects the cornea rather than the iris, visual quality is a major concern.

4. Why Eye Color Surgery Is Not Recommended for Cosmetic Use

The eye is extremely sensitive to changes in pressure, fluid dynamics and surface integrity. Cosmetic surgical attempts to change eye color can compromise these structures irreversibly. Some patients require multiple additional surgeries to manage complications.

Major ophthalmic associations advise against cosmetic use of implants or tattoo-based corneal procedures in healthy eyes.

5. Medical vs Cosmetic Indications

Surgery may be medically justified in cases such as:

• Aniridia or partial iris loss
• Traumatic iris damage
• Iris defects causing severe glare or photophobia
• Medical reconstruction after severe ocular injury

These indications are fundamentally different from cosmetic goals. Healthy eyes with normal anatomy should not undergo invasive color-changing surgery unless a medical reason exists.

6. How Do Surgical Methods Compare with Laser-Based Methods?

Surgical methods and laser depigmentation are not alternatives to be considered in the same category. Laser treatment is non-incisional and does not involve placing foreign material inside the eye. However, it is still experimental and carries its own risks.

For a full understanding of the differences, see our main reference page: Laser Eye Color Change.

Disclaimer: This page offers medical information and risk awareness, not a recommendation for any surgical procedure. Surgical decisions must be made with an experienced ophthalmologist after full examination.