Keratopigmentation Allows You to Change the Color of Your Eyes – but Is It Safe?

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Have you ever thought about changing the color of your eyes? If so, you’ve likely considered colored contacts, which many people find to be both freaky and cool at the same time. But what if we told you that you could permanently change the color of your eyes to be whatever you want – whether it’s blue, green, or even rainbow (more on that in just a moment)? Sounds too good to be true? Perhaps, but a procedure called keratopigmentation can do that just.

If you’re still a little skeptical (rightfully so), read on to learn more about the procedure and the risks involved with achieving your dream eye color.

What Is Keratopigmentation?

Corneal keratopigmentation (or KTP) “is a permanent eye color change procedure also known as ‘corneal tattooing,'” says Parisa Jalalat, OD, a therapeutic optometrist in Long Beach, CA. Believe it or not, keratopigmentation is not a new procedure. In fact, it has a long history of use in helping patients who experience disfiguring corneal opacities (or scarring of the cornea). Though it serves a therapeutic function, its cosmetic use has been viewed as controversial due to the riskiness of the surgery.

Keratopigmentation’s cosmetic use has been around for centuries. While different methods have been used and modified over the years, corneal tattooing was first described around 2,000 years ago by a Greek physician, according to a review from the journal Eye, and was referenced again by another Greek physician in the year 450. The procedure was performed to help mask white opacity (a white cast over the eye) or scarring of the cornea. The technique disappeared and was not mentioned again until the mid-19th century, when a new method of KTP was invented by oculoplastic surgeon Louis Von Wecker. Wecker’s method of placing Indian ink solution over the cornea and inserting pigment into the corneal tissue via a grooved needle influenced modern methods of keratopigmentation.

How Is Keratopigmentation Performed?

The procedure, which is not FDA-approved, involves using a needle or laser “to imbed pigment into the cornea, the front window of the eye, to change the appearance of the underlying iris color inside the eye,” says ophthalmologist Diane Hilal-Campo, MD, the founder of Twenty/Twenty Beauty.

“There are various KTP techniques, including superficial (superficial manual KTP and superficial automated KTP) and intrastromal (manual interlamellar KTP and FLAK) methods. FLAK, femtosecond laser-assisted keratopigmentation, is a newer technique trending on social media currently with less postoperative complications and recovery time compared to traditional KTP, but not without risk.”

The procedure allows you to choose any eye color you’d like. “I have a colleague performing this procedure who has given patients rainbow-colored eyes,” Dr. Hilal-Campo says. “The results are extremely predictable.”

During the procedure, the patient is awake. A surgeon will create a tiny slit or two in the clear surface of the eye (the cornea) where it covers the colored part of the eye (the iris). The surgeon will then create tiny channels that mimic the striations you see in a natural iris. “Once pigment is added, the surgeon will close the two openings and place a bandage contact lens over each eye, which the patient will need to wear for about two days until the eyes recover enough to remove them,” Dr. Hilal-Campo says. The procedure doesn’t actually alter the pigment of your iris; rather, a different color pigment is layered on top, with the final effect being a different eye color. “You can compare it to applying one shade of lipstick on top of another,” she says.

“Like colored contacts, the color change results depends on how much pigment is used and the new color overlaid,” Dr. Jalalat says.

Following the procedure, the patient will then take antibiotics for the next two weeks to prevent any potential infection.

Who Is a Good Candidate For Keratopigmentation?

Dr. Hilal-Campo says that there is no “good” candidate for the procedure due to the high-risk, low-reward nature of it: “No one should have it done.” However, Dr. Jalalat says, “KTP is a great option for those that are already blind and have an opacified cornea, for cosmetic purposes, which was the original intent of this procedure many centuries ago. But the bottom line is: it’s too risky for a healthy eye.” With no long-term data on the procedure, Dr. Hilal-Campo says, “We need to watch what happens in 20 to 30 years to the eyes that have had it done.”

Possible Complications of Keratopigmentation and Side Effects

No surgery comes without risk, but the American Academy of Ophthalmology warns against undergoing keratopigmentation due to the serious complications it carries. Risks and complications include permanent damage to the cornea, which can lead to cloudiness and vision loss; light sensitivity; a bacterial or fungal infection; leakage and uneven distribution of the dye; color fading due to leakage; and general reaction to the dye, which can cause inflammation or uveitis, which occurs when the middle layer of the eye gets swollen and red.

As the risks outweigh the cosmetic gain of having the eye color of your dreams, Dr. Jalalat recommends colored contacts. “The safest way to change the appearance of your eye color is FDA-approved colored contact lenses fit by an optometrist.”

The Cost of Keratopigmentation

The procedure can run you up to $12,000, depending upon geographical location, but the average cost in the United States is $9,649 (though it may cost less in other countries), and it’s not covered by insurance. Dr. Jalalat explains that the procedure, despite it not being FDA-approved, is performed off-label and is legal in the United States.

While the results of the procedure are meant to be permanent, “the pigment can fade over time, similarly to permanent cosmetics, which would require touch-ups,” Dr. Hilal-Campo says. “Blue is the most likely to fade because it is the least stable pigment.”

If you are still set on having the procedure despite the risks, Dr. Hilal-Campo says you must go to a credible and skilled board-certified ophthalmologist with decades of experience.

Taryn Brooke is a beauty writer and editor born and bred in New York City who has been in digital media for over 10 years. She is a contributing beauty writer for PS, Allure, Byrdie, and Well+Good.

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