Eye Color Change: Keratopigmentation versus laser depigmentation

P. Grimaldos
Barcelona Eyecos Clinic

Research Purpose:

The objective of this study is to compare the two most popular current techniques for changing eye color: kerato-pigmentation (KP) or corneal tattooing and laser depigmentation (DL) of the iris. Both procedures began to be performed a decade ago for cosmetic purposes, and we will analyze their pros and cons, in terms of safety, efficacy, predictability, and aesthetic result.
Materials and Methods We carried out a bibliographic review of the few scientific articles on the two techniques, as well as a compilation of the available iconography of the results and complications or side effects. The parameters to be compared are: indications, contraindications, clinical or surgical modality, risks of the procedure, functional and structural limitations, long-term drawbacks, early and late complications, long- and short-distance aesthetic results, cost of the technique, and price for the patient. patient.

Results:

Regarding the pathology indications, keratopigmentation is indicated for the repair of corneal leukomas or congenital or traumatic defects of the iris, and laser depigmentation for the treatment of congenital iris heterochromia and nevus, or secondary to iatrogenic diseases. disorders, traumas and complicated intraocular surgeries. Both techniques can be for purely cosmetic purposes. KP is contraindicated in corneal diseases and refractive surgery, as well as serious ocular pathology. LD is contraindicated in a history of glaucoma and uveitis. KP is a complex surgery performed in a sterile operating room, while Laser Depigmentation is laser performed in the office. The KP presents surgical risks of infection, scarring, and decentration, while the Laser Depigmentationonly presents a slight inflammatory reaction and slight elevation of ocular pressure of short duration. KP opacifies three quarters of the cornea, which limits the visual field for walking and driving during the day and especially at night. It is also contraindicated in patients who have undergone lasik or cornea surgery. The LD does not generate any type of functional limitation, since the media remain transparent and the pupil is reactive to light. Keratopigmentation prevents exploration of the chamber angle, corneal endothelium, visual field, and retina. Likewise, it prevents refractive, cataract, corneal, glaucoma, and retinal operations. The Laser Depigmentation does not limit any type of eye examination or the performance of eye interventions. Keratopigmentation can cause infection, irregular astigmatism, endothelial decompensation, decentration and pupillary irregularity, and intolerance and progressive dye leakage. Laser Depigmentation can cause mild iritis, with sensitivity to light and transient elevation of eye pressure. In the long term it has already been shown that there is no risk of glaucoma or uveitis or sensitivity to light. The aesthetic results are similar at long distance, but very different at medium and short. The Keratopigmentation always generates a very artificial appearance, “robot or doll”, because it uses chemical dyes and the pupil is irregular, large and does not react to light; On the contrary, in 100% of the cases of Laser Depigmentation the appearance is natural and the pupil is small, normal and reactive to light. The price to the patient of the keratopigmentation
It is around 7,500 euros, while the DL costs about 3,500 euros.

Conclusions:

Keratopigmentation should not be indicated for aesthetic purposes due to its surgical risks, functional and structural limitations, future exploratory and surgical drawbacks, disastrous cosmetic results, and high price. The only safe, effective, predictable technique with a natural aesthetic result is Laser Depigmentation. Unfortunately, we have detected misleading and malicious advertising about KP by the clinics that perform it, regarding its risks, contraindications, drawbacks, and real cosmetic results, which implies professional malpractice.