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Eye color-changing surgeries spark AAO warning

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The American Academy of Ophthalmology (AAO) has issued a warning to the public against receiving two eye color-changing surgeries that could pose serious risks for vision loss and complications.

First things first: which surgeries?

  • Iris implant surgery
  • Keratopigmentation

Give me some details on each.

Conducted as an outpatient procedure under local anesthetic, iris implant surgery involves iris reconstruction using prosthetic devices, where a surgeon inserts an artificial iris (made of silicone) through a slit cut into the eye at the cornea’s edge. From there, the artificial is unfolded inside the eye and moved to cover the natural iris.

Prior to 2018, U.S. ophthalmic surgeons were required to receive permission via investigational or compassionate use exemptions from the FDA for the use of iris implants. But as of May 2018, when the FDA approved the first stand-alone prosthetic iris, surgeons have since had options.

Target patients for this procedure: those missing part or all of their iris (a condition called aniridia) due to an injury or birth defect.

And keratopigmentation?

Commonly known as eye tattooing, keratopigmentation is a surgical procedure conducted on the cornea itself.

This involves a needle or femtosecond laser that creates space within the cornea, enabling a color pigment to be injected in order to permanently change the cornea from its natural clear appearance to opaque—covering the iris’s natural color, according to the AAO.

Target patients for this procedure: those suffering from disfiguring corneal opacities.

So, what’re the ocular risks for both procedures?

The AAO noted the following potential risks:

  • Iris implant surgery
    • Reduced vision or blindness
    • Light sensitivity
    • Elevated eye pressure (potentially leading to glaucoma
    • Cataract
    • Corneal injury
    • Iris inflammation
      • Eye pain, blurred vision, tearing
  • Keratopigmentation
    • Corneal damage
      • Cloudiness, fluid leakage, vision loss
    • Adverse reaction to dye
      • Inflammation, uveitis, or blood vessel growth into the cornea
    • Bacterial or fungal infection
      • Corneal scarring, vision loss
    • Uneven distribution of dye
    • Dye leakage into the eye
      • Fading

So why the warning now?

Per the AAO, these two procedures have risen in popularity on social media, with individuals undergoing the procedures for cosmetic reasons (changing their eye color) instead of serious health causes.

And the recommendation?

For individuals looking to change their eye color, the AAO recommends colored contact lenses (for suitable candidates, that is).

These, however, should only be “prescribed, dispensed, and fitted by a qualified eye health professional,” the AAO stated.

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