Complications And Management Of Cosmetic Iris Implants

Cosmetic iris implants, initially developed for medical conditions, have gained popularity for aesthetic eye colour alteration. Despite lacking regulatory approval, these devices are increasingly sought after, raising concerns about potential complications. This study aims to analyse the ocular complications and outcomes associated with cosmetic iris implants in the largest case series to date.

Moorfields Eye Hospital NHS Trust.

This was a retrospective review of 30 eyes from 15 patients who presented with complications related to cosmetic iris implants at Moorfields Eye Hospital between 2008 and 2023. Data collected included visual acuity, intraocular pressure (IOP), endothelial cell count, and surgical interventions. Statistical analysis included paired t-tests and multivariate logistic regression.

The median time to explantation was 45.5 months. Uveitis was the most common complication (60%), followed by corneal decompensation (36.7%) and raised IOP (30%). Post-explantation, ten eyes (30.3%) underwent glaucoma surgery, six eyes (20%) had Descemet's membrane endothelial keratoplasty, and four eyes (13.3%) needed cataract surgery. A statistically significant correlation was found between time to explantation and corneal decompensation (r = 0.392, p = 0.048). Mean IOP decreased significantly from 22.17 ± 11.36 mmHg to 13.82 ± 4.56 mmHg post-explantation (p = 0.001).

Cosmetic iris implants are associated with significant ocular complications, often requiring multiple surgical interventions even after explantation. The risk of corneal decompensation appears to increase with longer implant duration. These findings highlight the importance of patient education regarding the potential risks of these unapproved devices and raise questions about their long-term safety and ethical implications.