Achieving a change in eye color is a cosmetic goal desired by many individuals. For this reason, the temporary use of colored contact lenses remains highly popular. However, in recent years, several unconventional surgical techniques have emerged, offering the possibility of permanent eye color alteration despite insufficient scientific evidence to support their safety and efficacy. One of these methods is corneal pigmentation (tattooing of the cornea).<br /> <br />Methods<br /><br />1. Artificial Iris Implantation<br />A silicone-based implant is inserted into the eye to alter the appearance of the iris.<br /><br />2. Iris Depigmentation by Laser<br />A novel technique that employs laser energy to remove melanin pigment from the iris, resulting in a lighter eye color.<br /><br />3. Permanent Colored Intraocular Lenses<br />Implantable tinted lenses are placed inside the eye. These devices may provide permanent color change but are associated with potential complications.<br /><br />4. Corneal Pigmentation (Tattooing)<br />Corneal tattooing or cosmetic pigmentation can be performed either in blind or sighted eyes to camouflage iris defects or corneal opacities.<br /> <br />Indications and Motivations<br />• Cosmetic desire for eye color change<br />• Correction of congenital iris abnormalities<br />• Compensation for trauma or disease-related damage<br /> <br />Mechanisms of Action<br />• Implants: A silicone device is placed to cover the natural iris.<br />• Laser: Laser energy disrupts and removes melanin pigment through vascular clearance.<br />• Corneal Tattooing: Approved pigments are injected into corneal stromal tunnels for cosmetic masking.<br /> <br />Techniques<br />1. Iris Implant Surgery<br />2. Laser Iris Depigmentation<br />3. Cosmetic Corneal Tattooing<br /> <br />Management and Post-Operative Care<br />• Topical intraocular pressure–lowering drops<br />• Surgical intervention in case of complications<br />• Anti-inflammatory regimens<br />• Regular follow-up, including intraocular pressure (IOP) monitoring and endothelial cell count assessment<br /> <br />Risks and Complications<br />• Chronic dry eye<br />• Corneal ectasia with significant thinning<br />• Photophobia (light sensitivity)<br />• Allergic reactions<br />• Cataract formation<br />• Obstruction of aqueous humor outflow<br />• Secondary glaucoma<br />• Uveitis<br />• Corneal opacification and loss of transparency<br />• Visual impairment<br />• Permanent blindness<br /> <br />Current Scientific Evidence<br /><br />At present, according to statements from leading international ophthalmology societies, there is no sufficient scientific evidence to support corneal pigmentation as a safe or recommended method for permanent eye color change, particularly in patients with healthy eyes. Its clinical use remains restricted to therapeutic or reconstructive purposes, such as improving cosmetic appearance in eyes with pathological conditions (e.g., scars or opacities).<br /><br />For this reason, ophthalmologists strongly emphasize that social media claims promoting these procedures for purely aesthetic reasons should not be trusted. Furthermore, these interventions are not performed for cosmetic indications in standard medical practice.<br /> <br />Clinical Recommendation<br />• These procedures should not be pursued solely for cosmetic purposes.<br />• A full ophthalmological evaluation by a specialist is essential prior to considering any intervention.<br />• Among available options, corneal tattooing remains the most customizable and relatively less invasive, but it is primarily reserved for therapeutic indications rather than elective cosmetic enhancement.<br />