The first world congress of surgeons specialising in eye color change was held in Alicante on 24 May 2024. For the first time, it brought together all the world's specialists in eye color change.
Both future patients and the medical world needed this. With the coexistence of different techniques, different protocols and, above all, a great deal of misunderstanding on the subject, this provided an opportunity to present the different existing techniques and protocols for changing eye color.
There are several techniques that have existed for many years in different countries. There are also many different points of view, which adds to the confusion in this nascent market in need of clarification. This is therefore an opportunity to take stock of the protocol or protocols for the eye color change technique known as keratopigmentation.
So the question is, does changing eye color really work?
When it comes to surgery, there are many techniques and protocols, often different, and this reflects the diversity of opinions. One surgeon will use the protocol developed by surgeons who have developed a protocol before him. Another surgeon may prefer to follow another school of thought or simply try to develop his own technique.
While it is difficult to sort out all the techniques for changing eye color, it is easy to say that a distinction must be made between keratopigmentation with a purely therapeutic aim and others. In fact, keratopigmentation, to a certain extent invented and developed over the last thirty years by Dr Alio in Alicante, was solely for therapeutic purposes.
As time goes by and technology (in particular refractive surgery lasers and pigments used by certified laboratories) permits, the logical evolution of keratopigmentation is to become aesthetic as well.
In the next few years, keratopigmentation will no doubt not be a sub-category of cosmetic surgery or ophthalmology, but a new and distinct category which will be aesthetic ophthalmology.
Without going into the technical details, it is also important to distinguish between purely aesthetic keratopigmentation and keratopigmentation that has a therapeutic purpose but provides an aesthetic improvement. This is important because the qualification of keratopigmentation in certain countries by the Ministries of Health or other local FDAs focuses mainly on this difference.
So the question will be whether keratopigmentation is used for aesthetic purposes to repair a medical problem (for example, an accident resulting in the loss of color in one eye) or is it purely aesthetic?
As there are as many keratopigmentation protocols as there are clinics offering it, we can distinguish between keratopigmentation protocols offering a certified protocol and non-certified keratopigmentation protocols.
The keratopigmentation protocol(s) must be distinguished according to whether the protocol includes one or more certified stages. Certified means that the equipment used and the process are in part validated by recognised health authorities. In general, these are the Medicines Authorities, the local Ministry of Health or an agency such as the FDA in the United States.
This certification is important because it validates all or part of the eye color change protocol.
Let's take a look at the clinics offering keratopigmentation in Europe, such as the New Color clinic in Nice. These clinics have the advantage of using pigments that are certified, bio-compatible and validated by the European Health Authorities. This means that an essential part of the keratopigmentation protocol includes an element that has been validated by external third parties and has passed all the tests for reactions in the human body, such as toxicity, etc.
Another essential element of the keratopigmentation protocol is the equipment used. The keratopigmentation technique uses refractive technology with lasers used in refractive surgery. The Zeiss VisuMax 800 laser is widely considered to be the best laser for this purpose.
So, to put it simply, if you want real keratopigmentation using the right pigments and the right equipment, your eye color change needs to take place in a clinic that uses refractive surgery.
The advantage of the keratopigmentation technique is that it does not touch the iris, making it a minimally invasive procedure.
To find out whether a person is eligible for the keratopigmentation technique, short tests lasting no more than 15 minutes are recommended before coming in, and can be carried out at any ophthalmologist, vision clinic or even shops selling glasses. In general, you will be asked to:
- corneal topography and pachymetry
- macular OCT + RNFL
- an endothelial count
You should also ask whether the clinic is certified by ISO or JCI, for example, and what your ophthalmologist's curriculum vitae is.
Standard protocol for certified keratopigmentation :
What can we learn from this protocol?
In addition to the previous protocol, there are numerous protocols for eye color change surgery under the term "keratopigmentation" or other techniques generally known as eye color change.
Starting with clinics talking about keratopigmentation, it should be noted that this term is used by many clinics even though there is not necessarily any certification.
In terms of pigments, there is generally no traceability of the pigments used. Very often, food pigments or pigments obtained "illegally" are used. We talk about 'illegal' pigments because in many countries, when a 'product' that is foreign to the human body is used and left permanently, especially in the eyes, it is considered risky, invasive and can cause obvious tolerance problems.
Under recent European legislation applying to the 27 countries of the European Union, the pigments used must meet very strict standards and are classified as "medical devices". So any ophthalmologist or clinic that does not use pigments certified as "CE marked" or "FDA approved", for example, will not be complying with the standards imposed by the local health authorities, and could potentially be endangering the vision of their patients.
All you have to do is ask the future clinic that will change the color of your eyes what pigments are used, whether they are micronised and what tests they have undergone.
Apart from the pigments, you should also find out about the background of the ophthalmologist who will be operating on you. You should ask for his curriculum vitae and find out what techniques he has mastered and how many cases he has operated on. Your ophthalmologist must be trained in refractive surgery and be familiar with the laser and the software that goes with it.
The other key point is to ask which laser is being used for your keratopigmentation. You need to ask how old the laser is and, above all, what brand and reference it is. These questions are essential and will determine whether your keratopigmentation will be carried out in optimum conditions of comfort and safety.
An obsolete or unsuitable laser can present a problem for your keratopigmentation, as well as causing discomfort and lengthy protocol times.
So the protocol compared with the certified protocol will mean more treatment time to create the micro-tunnel allowing pigment insertion, an increased risk of complications and generally a process that is not legally compliant.
All this naturally leads us to ask the question and try to answer it: does keratopigmentation really work?
The general public, those who want to change the color of their eyes, are lost. If you look on the internet, there are lots of different clinics, lots of techniques and protocols and, above all, more or less clear comments.
There are "real keratopigmentations", "fake keratopigmentations", ancient depigmentation techniques, corneal tattooing techniques and corneal transplants. Each clinic will tell you that everything is fine, that they have mastered their technique for years and that many cases have been positive.
Clinics will rarely give you information on the protocol, pigments or equipment used, unless they are certified.
You will then see many alarming before-and-after photos of eye color changes on the internet, and you will no doubt become aware not of the risks of keratopigmentation but of the risks posed by certain clinics and techniques that do not respect the law or existing protocols in this area.
Your keratopigmentation will work perfectly and without complications if you follow these major principles.
First of all, you need to follow the protocol recommended by your ophthalmologist and carry out the preliminary tests requested.
It only takes a few minutes, and not only saves you a trip if you weren't eligible, but also helps you to prepare your application properly for ophthalmologists, who receive a huge number of applications and generally only select those that are 'ready'.
Then you need to have a consultation with the ophthalmologist, which also only takes a few minutes and you don't need to travel, it's done by video via Whatsapp or Zoom.
To book, simply validate the quote received or the deposit (usually around 5% of the final price) before coming.
Keratopigmentation involves using a Femtosecond laser to create a "micro-tunnel" in the thickness of the cornea.
Contact between the eye and the laser lasts just a few seconds and you feel nothing at all.
Thanks to this small tunnel, the ophthalmologist specialising in eye color changes will be able to insert the pigments quickly over a period of a few minutes.
The ophthalmic surgeon's experience and "artistic" side will then come into their own. All his work will focus on the harmonious distribution of pigments, taking into account the natural relief of the eye, and how to leave the limbal ring naturally in order to maintain contrast for the most natural result possible.
The main technical advantages of keratopigmentation over other techniques :
The vast majority of patients make no comments after keratopigmentation and only a small majority say that their eyes feel dry or that they have a phobia of light for a few hours. These symptoms disappear within 48 hours.
Keratopigmentation can therefore be considered to be the only effective and risk-free technique for changing eye color, and any other technique can therefore be ruled out.
Given that the world now has a reliable and effective technique through keratopigmentation, other techniques that have become obsolete or dangerous should be avoided.
Iris grafting is by far the riskiest technique. While keratopigmentation is minimally invasive, iris grafts are by far the most invasive and risky.
In practice, you're touching the eye completely, using a technique that serves no purpose when all you need to do is "add" a layer of pigment without changing the "whole eye".
In addition, this technique has been the subject of a number of very negative reports over the years, and is almost no longer offered anywhere in the world.
The technique of depigmentation is still widespread throughout the world. It can be found in almost all countries, particularly those with a high level of medical tourism, such as Turkey.
As luck would have it, it appears to be less expensive than keratopigmentation and therefore attracts a lot of attention. In our opinion, this technique is misleading future patients and needs to be looked at more closely.
First of all, it causes a lot of confusion because it uses a laser, just like keratopigmentation. The general public often thinks that it is also keratopigmentation because a laser is used, but it is not.
A laser is used, not to open a micro-tunnel in the cornea and insert pigments, but to depigment the melanin cells in the eye.
It is therefore a depigmentation and not a pigmentation.
So you can't choose the color.
This technique is banned in some countries and has been of no real use since keratopigmentation was introduced.
The main disadvantages are :
Of course, there are many other solutions for changing eye color. We do not recommend any solution that does not correspond to surgery in general, and even less so if it does not include certified elements such as pigments or a refractive surgery laser.
We advise you to avoid so-called "natural" solutions based on foods such as lemons and other miracle fruits, as these do nothing to help and can lead to frustration if not problems.
Then there's the question of contact lenses. Contact lenses are an easy and temporary solution for changing eye color. There's no denying their practicality and low cost, but they're only temporary, often unnatural and can present risks of infection.
So there really can be no comparison between contact lenses that still require daily monitoring with very unnatural results and permanent surgery that makes it look as if a person has natural eye color.
Once the choice has been made between the graft and the right laser used in refractive surgery, there's more to come.
It is important to distinguish between genuine keratopigmentation and fake keratopigmentation. Unfortunately, all you have to do is type the word "keratopigmentation" on the Internet and you will be offered services all over the world that claim to be keratopigmentation but are not.
Have a lot of questions about eye color change and keratopigmentation? find out all eye color change answers.
In almost every major capital city, you'll find clinics offering miracles and "perfect mastery" of the keratopigmentation technique.
As explained, we suggest you check for yourself and ask them a few questions to make an informed choice.
We recommend that you ask what type of laser is used, what pigments are used and who is the qualified ophthalmologist?
You need a Zeiss VisuMax 800 refractive surgery laser, and in 2024 there will be fewer than 15 centres in the world that have one, given the price tag of around $600,000.
Indirectly, this makes it possible to distinguish between clinics and, from the outset, to be wary of any ophthalmologist who gives the impression of doing surgery "out of his corner".
Next, your ophthalmologist must provide you with proof of his or her expertise and experience. In particular, he must provide you with his diplomas, how many surgeries he has performed and to which association or legal entity he belongs so that knowledge can be shared between practitioners in this field.
Finally, if you don't want to get pigments in your eyes that you don't know the origin, composition, tolerance to the human body and, above all, toxicity of, ask what pigments are used.
We only recommend micronised pigments whose composition is biocompatible and certified by the Health Authorities of a country as "CE Mark" or "FDA approved".
So it's safe to say that the first thing to avoid is easy, inexpensive solutions that don't involve surgery. That goes without saying, but how can you change the color of your eyes with miracle products? If it existed, we'd know about it.
Then, by focusing on what aesthetic medicine, or more precisely the new aesthetic ophthalmology, has to offer, we have to sort out the good surgeries from the bad.
If you avoid obsolete or dangerous techniques such as iris transplants or lasers that depigment melanin cells, the keratopigmentation technique remains as explained.
Unfortunately, there are also some unscrupulous clinics and ophthalmologists in this field, so you have to distinguish between those that give real results in terms of color and absence of complications and those that do not.
Keratopigmentation works if you choose the right one. You can contact us to discuss this.
The results are truly extraordinary and natural.
Updated October 2024
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