D'Oria Francesco, Alio Jorge L
Section of Ophthalmology, Department of Translational Biomedicine and Neuroscience, University of Bari, Bari, Italy.
Vissum (Miranza Group), C/ Cabañal, 1, 03016, Alicante, Spain.
Ophthalmol Ther. 2025 Jun 7. doi: 10.1007/s40123-025-01177-0.
The desire for permanent cosmetic change of eye color has driven the development of various surgical techniques aimed at achieving this transformation, pursuing more enduring solutions. This demand has led to the emergence of three primary surgical approaches: cosmetic iris implants, laser iris depigmentation, and cosmetic keratopigmentation (KTP). Each technique presents distinct advantages, yet also entails specific limitations and potential risks. Cosmetic iris implants, originally designed for congenital or traumatic iris defects, have been repurposed for aesthetic use. However, they come with severe risks, including glaucoma, corneal endothelial cell loss, and even permanent vision impairment. As a result of these complications, they are not approved by major regulatory bodies and are widely considered unsafe. Laser iris depigmentation offers a less invasive approach, using a Q-switched Nd:YAG laser to remove melanin from the anterior iris stroma. While it provides a natural-looking result, it lacks customization and has potential complications like patchy pigmentation, photophobia, and temporary intraocular pressure spikes. Additionally, there is limited long-term data on its safety. Cosmetic KTP, an advanced version of corneal tattooing, has emerged as the safest and most effective option. It involves embedding micronized mineral pigments into the cornea, allowing for precise, customizable, and long-lasting results. Studies show high patient satisfaction and minimal risks when properly performed. Among these techniques, KTP appears to be the best choice owing to its safety and aesthetic flexibility, while cosmetic iris implants should be avoided because of their high risk of complications, and laser iris depigmentation deals with limitations in color selection and long-term reliability. While KTP currently seems the safest option for cosmetic eye color change, this is largely based on limited single-center data and should be confirmed by larger studies in the future.
对眼睛颜色进行永久性美容改变的需求推动了各种旨在实现这种转变的手术技术的发展，人们追求更持久的解决方案。这种需求导致了三种主要手术方法的出现：美容性虹膜植入、激光虹膜色素脱失术和美容性角膜色素沉着术（KTP）。每种技术都有独特的优势，但也有特定的局限性和潜在风险。美容性虹膜植入最初是为先天性或外伤性虹膜缺陷设计的，现已被用于美容目的。然而，它们伴随着严重风险，包括青光眼、角膜内皮细胞丢失，甚至永久性视力损害。由于这些并发症，它们未得到主要监管机构的批准，被广泛认为不安全。激光虹膜色素脱失术提供了一种侵入性较小的方法，使用调Q Nd:YAG激光从前部虹膜基质中去除黑色素。虽然它能产生自然的效果，但缺乏定制性，并且有潜在并发症，如色素沉着不均、畏光和暂时性眼压升高。此外，关于其安全性的长期数据有限。美容性KTP作为角膜纹身的升级版，已成为最安全、最有效的选择。它涉及将微粉化的矿物色素嵌入角膜，可实现精确、可定制且持久的效果。研究表明，正确操作时患者满意度高且风险极小。在这些技术中，由于其安全性和美学灵活性，KTP似乎是最佳选择，而美容性虹膜植入因并发症风险高应避免使用，激光虹膜色素脱失术在颜色选择和长期可靠性方面存在局限性。虽然目前KTP似乎是美容性改变眼睛颜色最安全的选择，但这很大程度上基于有限的单中心数据，未来应由更大规模的研究加以证实。
