Penningtons Manches’ cosmetic surgery team voices safety concerns about new laser procedure to turn brown eyes blue

Posted: 19/03/2015

Cosmetic eye surgery is becoming increasingly popular for those who want a more permanent solution to changing their eye colour than coloured contact lenses. With just 17% of the population having blue eyes, the most desired colour, a new laser procedure to permanently turn brown eyes blue is currently undergoing clinical trials to meet the rising demand for this type of surgery. 

The Penningtons Manches specialist cosmetic surgery team has previously warned about the risks of artificial iris implants (see article here), a procedure that permanently changes eye colour. Artificial iris implants were advertised as an alternative to laser-based procedures, on the basis the implants can be removed if there are complications, but this does not mean they are without risk. 

A Californian company has reported that it hopes to offer a new cosmetic procedure using a low energy laser. The laser is used to trigger ‘scavenger cells’ which digest and remove the pigment from the iris surface. 

Dr Gregg Homer, chairman and chief scientific officer at Stroma Medical, which is pioneering the procedure, commented: “Under every brown eye is a blue eye. The only difference between them is that a brown eye has a thin layer of pigment covering the blue iris. If you take that pigment away, then the light can enter the stroma - the little fibers that look like bicycle spokes in a light eye - and when the light scatters it only reflects back the shortest wavelengths and that's the blue end of the spectrum."

The procedure uses a computer-guided, low-energy laser with a specific frequency which passes through the clear cornea of the eye before it is selectively absorbed by the dark pigment covering the iris. According to Stroma Medical’s website, the laser causes the body to “initiate a natural and gradual tissue-removal process. Once the tissue is removed, the patient's natural blue eye is revealed.” 

The procedure takes 30 seconds and the blue iris will be revealed two weeks later. The proposed cost for the laser treatment will be $5000. However, at this stage, the procedure is not available to the public as it has only undergone a limited study in 17 patients in Mexico and 20 in Costa Rica. Stroma Medical has confirmed that, to date, there has been no reported adverse events and it will continue with the trials, extending it to 100 patients worldwide.  

Saj Khan, an ophthalmologist at the London Eye Hospital, told CNN that the procedure could “clog up the eye's normal drainage channels. This can in turn cause the pressure inside the eye to go up. If that happens significantly enough, for long enough, it's how patients develop glaucoma.” 

Stroma Medical has confirmed on its website that it was “concerned about this issue right from the start, so it was the first issue we tested and measured in our initial pre-clinical and clinical studies. Thus far, pigmentary glaucoma has not proved to be a problem.” The company claims that the particles released by the process are too fine to cause glaucoma and that any complications are likely to be short term and easily remedied.  

Commenting for the Daily Mail, Dr Mark Korolkiewicz, an optometrist and clinical services director at Ultralase, a nationwide laser vision correction specialist, voiced his concerns and explained the fundamental differences between the Stroma laser procedure and corrective laser eye surgery. He said: “the basic rule of thumb is that as soon as you go inside the eye with a laser, you can cause more damage.” For laser vision correction, he confirmed “we only use lasers on the cornea, the surface of the eye. This new treatment involves using a laser inside the eye.” 

Sarah Gubbins, associate in the specialist cosmetic surgery team at Penningtons Manches comments: “This new laser procedure to remove dark pigmentation from the iris is undergoing clinical trials and therefore not currently available to the public. However, as cosmetic eye surgery is increasing in popularity with iris implants, eye whitening and even eye jewellery, we suspect that this procedure is likely to be very popular if it is made available to the public.  

“Although the limited results from the current trials seem to be reassuring, no procedure is without risks. We need to see long term outcomes before we know the true risks to eye health. Given the importance of vision, we are naturally cautious about cosmetic procedures for the eyes and we share the specialist ophthalmologists’ concerns about the potential complications that could develop.” 

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