Permanent eye color change: New procedure may not be worth the risk

Want to change those brown eyes blue? Well, a new procedure promises to change eye color — forever — using iris implants made in various colors.

Iris implants are not yet approved in the United States for cosmetic use, but it hasn’t stopped Americans from traveling outside of the country to have the procedure done.

Several YouTube videos show before and after images of people who say they have had BrightOcular implants placed in their eyes.

In one video, a young African-American man desires grey eyes because he wants “a brand new me.” After surgery, he says the procedure caused him no pain.

“It was 15 minutes per eye,” he says. “It was great.”

In another video, a young woman says that she felt pain the evening after the surgery, “but it was really okay,” and that now, “I feel like someone new.”

The downside? They’re possibly risking their vision to have the look that they want.

Not all roses

Dr. James Tsai, clinical spokesperson for the American Academy of Ophthalmology and glaucoma specialist at Yale University, says there’s a lot of marketing at play.

“These companies have paid some of these patients who have gone through this to provide testimonials to the benefits,” he says.

“They start out by saying it’s just like a cataract surgery… that it usually goes very well, and it’s usually a safe procedure,” he says. “But they don’t go into detail about all of the complications. The side effects and dangers are minimized.”

BrightOcular denies that they have ever paid for testimonials or paid models to appear in them.

Multiple studies have highlighted the risks of iris implant procedures, including blindness, glaucoma, scarring of the cornea, sensitivity to light or the development of cataracts.

But, according to Tsai, these risks aren’t always shared with the patient.

Once complications occur and the implant has to be removed surgically, that can pose its own set of problems.

“In one of my patients, the surgeon tried to remove it and when he pulled away the implant, it ripped off her natural iris and she no longer had a natural-looking pupil,” Tsai recalls.

What’s behind those eyes?

The iris, a ring of muscle fibers surrounding the pupil, is what determines eye color. During the procedure, eye surgeons place artificial irises underneath the top layer of the eye (cornea), covering the patient’s natural iris. The result is that only the artificial iris is showing in the selected color.

Iris implants were first made for people whose irises did not develop normally at birth, or people who had damage to their eyes, such as burn victims. This particular type of implantation has been approved in the United States for some time. However, cosmetic iris implants are a new endeavor.

Dr. Shibu Varkey, an eye surgeon in India referred to theGrio by BrightOcular, first started using their implants on patients with iris abnormalities.

“These patients, who earlier, were unable to face even daylight, now were able to do so,” he says. “The overall quality of these patients’ lives improved.”

Varkey found BrightOcular while searching online for a patient of his — a young boy whose iris was badly damaged in an accident.

“The stringent selection criteria of candidates for the procedure… was technically and scientifically sound, so I decided that this was a promising product for this situation.”

The procedure has only been done in India for a little over a year. Varkey has personally implanted irises in 24 eyes in patients from several countries. Eighteen were for cosmetic purposes.

“This implant can also be used for those persons who would want to permanently change the color of their eyes of cosmetic reasons, like persons involved in show business, who are intolerant to cosmetic contact lenses due to medical reasons or due to difficulty in its use and maintenance,” he explains.

However, Varkey cautions that before embarking on this procedure, patients should have a thorough eye exam, including measurement of eye pressure and careful study of the retina. He is part of a team of researchers who are now gathering data to ensure the implant’s safety and to gain FDA approval in the United States.

In an email to theGrio, a representative from BrightOcular wrote that they anticipate having a CE mark — a certification that says a product has met the European Union’s health, safety, and environmental requirements — in 18 to 24 months.

Temporary solutions also risky

Those who prefer a more temporary solution to eye color change may consider color contacts. However, eye surgeons warn against the over-the-counter kind — those sold at beauty supply stores, costume stores or on the Internet.

“It’s a recipe for disaster,” says Dr. Thomas Steinemann, professor of ophthalmology at Metro Health Medical Center in Cleveland, Ohio. “There is no fitting, no instruction, no involvement of a qualified professional and therefore no follow-up.”

Infection and scar tissue leading to vision loss are the biggest concerns.

“If one person gets it, that’s one person too many,” Steinemann says. “[These consequences] are avoidable.”

Contacts — which are considered medical devices — that are sold without an eye doctor’s prescription or an eye exam are being sold illegally. And most are not even FDA-approved.

“If you want to change your eye color, do so with the help of an eyecare professional,” Steinemann suggests.

Laser techniques

Other sites advertise laser eye surgery to permanently change eye color. The theory is that the laser destroys the pigment cells that create an iris’ naturally dark coloring. Without this pigment, darker-colored eyes begin to look blue. In fact, one site states that it cannot make dark brown eyes light brown — only blue.

However, this procedure is not yet available.

“It’s only in testing phases,” says Steinemann, who has heard of the technique. “It’s not being done on human subjects yet.”

Beauty, at a cost?

The concept of risking vision for aesthetics raises similar questions as the ones asked about plastic surgery and the psychology behind it. Dr. Alfiee Breland-Noble says they’re both related to what constitutes beauty in our society.

“My guess is that people are not going to get iris transplants to make their eyes darker,” she says. “It’s either blue or green or hazel, and to me, that speaks to this idea that there is one ideal.”

Breland-Noble, professor of psychiatry at Georgetown University Medical Center, adds that, in the United States, the standard of beauty is very light with very European features, and arguably, blonde hair.

“The further you deviate from that, the more the person feels they’re not meeting a standard,” she says. “It doesn’t surprise me that they would want to make those kinds of changes, but it’s the mechanism they’re going through that’s shocking.”

The majority of people Tsai has seen sign up for this procedure are young adults. Psychologically, this happens to be a vulnerable time when identity and self-esteem is still being developed.

“If you’re comfortable with yourself, you’re less likely to do something that drastic and permanent,” says Breland-Noble.

Tsai says that having the procedure done at a young age is also problematic, because they have to live for a long time with the consequences of the procedure.

“The eyes are incredibly delicate and have to last a lifetime,” he says. “These [implants] can cause problems for the rest of their lives.”

Although, he’s not saying “absolutely not” to the procedure.

“People have a different tolerance for risk,” he explains. “But, they need to know. If you’re going to enter into this, know that you are doing something that’s a bit risky. Are you willing to take that risk?”

Varkey says he has not had any patients with complications, and has even removed implants and re-implanted them without difficulty for a patient who wanted a change of color.

Dr. Tyeese Gaines is a physician-journalist with over 10 years of print and broadcast experience, now serving as health editor for theGrio.com. Dr. Ty is also a practicing emergency medicine physician in New Jersey. Follow her on twitter at @doctorty or on Facebook

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