Keratopigmentation

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Permanent eye color change using a femtosecond laser and certified pigments

Keratopigmentation (also known as cosmetic corneal tattooing) is an innovative ophthalmic surgical procedure designed to achieve a permanent eye color change. Today, it is widely considered the most advanced option for patients seeking a natural-looking and long-lasting result.

Unlike iris implants or laser depigmentation, keratopigmentation does not enter the inside of the eye. It relies on biocompatible pigments specifically developed for ophthalmic use, which helps reduce the risk of major complications when performed by qualified specialists.

What is Keratopigmentation?

Keratopigmentation is a surgical technique that changes the appearance of eye color by placing pigments within the cornea. The procedure typically combines several advanced components:

High-precision femtosecond laser to create an intrastromal corneal tunnel
Certified pigments specifically intended for medical ophthalmology
Advanced refractive-grade techniques for a natural-looking aesthetic result
Dedicated planning software to simulate the expected shade pre-operatively

Often referred to as the FLAAK method (Femtosecond Laser Assisted Annular Keratopigmentation), the procedure takes roughly 15–20 minutes per eye and is usually painless under topical anesthesia. Many patients notice an immediate visible change after treatment.

Available shades

Keratopigmentation can create different natural-looking shades such as light blue, blue, green, aqua green, honey, grey and hazel. The final result depends on the base iris tone and is customized during the pre-operative consultation.

How does the procedure work?

Keratopigmentation is performed through a structured set of steps:

Pre-operative consultation: eye health assessment and shade simulation
Topical anesthesia: anesthetic eye drops to ensure comfort
Tunnel creation: femtosecond laser creates a thin annular corneal tunnel
Pigment placement: certified pigments are placed inside the tunnel
Post-operative check: immediate verification and prescription of eye drops

Watch out for non-certified pigments

Some providers may still use pigments not approved for ophthalmic use (sometimes intended for other industries). Always confirm that the clinic uses pigments specifically certified for keratopigmentation, with clear traceability.

Is Keratopigmentation safe?

Safety depends on three critical factors:

1. A qualified surgeon

Must be a licensed ophthalmologist
Experienced in refractive surgery and femtosecond laser procedures
Should demonstrate a significant number of keratopigmentation cases
True high-volume experts remain relatively rare worldwide

2. The right technology

Femtosecond laser with appropriate specifications
Advanced corneal tunnel planning software
Sterile instrumentation and certified surgical environment

3. Certified pigments

Pigments developed specifically for ophthalmology
Biocompatibility testing and ocular safety validation
Manufacturer traceability and certification

Potential risks

With unqualified providers or non-certified pigments, risks may include visual disturbance, ocular infection, pigment dispersion, increased intraocular pressure and, in severe cases, vision loss. Choosing a certified clinic and an experienced surgeon is essential.

Key questions to ask before the procedure
1) What is the surgeon’s experience in keratopigmentation?
2) Which laser technology is used?
3) Which pigments are used and are they certified?
4) How many procedures has the surgeon performed?
5) What follow-up, guarantees, and post-op support are provided?