HISTORY OF TREATMENT OF IRIS HETEROCHROMIA

Ocular cosmetic alterations have been treated conservatively so far with contact lenses and aesthetic prostheses, and through different types of surgical interventions. Deformities, irregularities, defects (colobomas) or total absences of the iris (anhiridia) have been treated with intraocular implants (Ophtec, Morcher or Dr Schmidt). In order to solve the cases of congenital or acquired tattoos of the cornea, contact lenses and prostheses or surgical keratopigmentation have been used. Regarding pigmentary disorders of the iris, such
as heterochromias, uni or bilateral, partial or complete, and nevus, single or multiple, there has been no safe and effective permanent solution other than cosmetic contact lenses. Given that the safety and effectiveness of contact lenses is very high, any surgical solution that puts visual health at risk should be evaluated with great care. Up to now, the surgical techniques proposed to treat iridian pigmentary problems have been mainly two: the cosmetic intraocular lenses (Newiris, Brightocular) and (Neoris, Corneal Eye Tattoo). According to our point of view these two techniques should not be indicated for safety reasons and aesthetic results. Regarding intraocular lenses, they provoke a clear confl ict of space in the anterior chamber, which causes glaucoma, uveitis and irreversible endothelial damage [1-10]. Due to these serious complications, implants must be removed after a few months [11-13]. In
relation to surgical keratopigmentation, cases of corneal complications have also been described, but cosmetic problems are more evident. The biological dye introduced into the cornea progressively disappears by diffusion over time, so the color fades, and on the other hand, the best result obtained never improves the result of cosmetic contact lenses, so its realization is meaningless . In both cases, the effect is always artifi cial, “robot eye”, with fi xed pupils that do not react to light, synthetic and weird colors, and functional limitations of the visual fi eld, together with photophobia and glare.