During iris implant surgery, an artificial iris made of silicone is folded and inserted into a slit that has been cut into the cornea. Then the iris is unfolded and adjusted to cover the natural iris. Local anesthesia is used.

Iris implant surgery was developed to treat people who have an iris that did not develop normally (for example, in conditions such as aniridia or coloboma) or who lack a natural iris, most often seen after a traumatic injury to the eye. These patients also risk complications from implant surgery, but the benefits of gaining an iris may outweigh their risks. Complications appear to be more common in people who have functional natural irises and yet chose implants for cosmetic reasons.

Studies show that serious complications of the iris-implant procedure can include:
  • Reduced vision or blindness;
  • Elevated pressure inside the eye that can lead to glaucoma, a potentially blinding disease;
  • Cataract (clouding of the eye's naturally clear lens);
  • Injury to the cornea, the clear outer area of the eye that focuses light and makes vision possible. If severe enough, a corneal transplant may be needed;
  • Inflammation of the iris or areas around it, leading to pain, blurred vision and tearing.
  • When complications occur, the implants often must be removed via additional surgery, which carries its own risks of damaging the eye. In one study, nine of 14 patients needed their implants removed.

Cosmetic iris implants have not been evaluated by any U.S. regulatory agency or tested for safety in clinical trials. They are not approved by the U.S. Food and Drug Administration. Currently, Americans who want the surgery travel to Panama, where the procedure is performed by several doctors.

The American Academy of Ophthalmology, the American Glaucoma Society and the Contact Lens Association of Ophthalmologists strongly discourage consumers from undergoing this surgery, due to the documented potential damage to healthy vision.

Anyone interested in changing their eye color – for whatever reason – should talk to an ophthalmologist before undergoing any procedure or purchasing colored contact lenses (which, by law, require a prescription).