Complications secondary to cosmetic artificial iris anterior chamber implants: a case report

BACKGROUND: Artificial iris anterior chamber implants were originally developed for therapeutic purposes but have been used recently for the cosmetic alteration of eye colour. There is a growing body of evidence surrounding their associated risks. We report a case presenting with complications secondary to bilateral NewColorIris® implants, including the first report of pressure-induced stromal keratopathy in this context. CASE PRESENTATION: A thirty-eight year old South American man presented as an emergency in the UK with best corrected visual acuities of 1/60 OD and 6/18 OS, bilateral corneal decompensation, lens opacities and raised intraocular pressures 4 years following bilateral NewColorIris® implantation in Panama. Anterior segment optical coherence tomography demonstrated the direct apposition of the implant with the iris and iridocorneal angle, together with pressure-induced stromal keratopathy with a fluid interface between the corneal stroma and previous laser-assisted in situ keratomileusis flaps. We describe the successful combined medical and surgical management in this case to yield a final visual acuity 6/12 in both eyes. CONCLUSION: Artificial iris anterior chamber implants are associated with sight-threatening complications that can present years after their implantation. We caution against their use for the cosmetic alteration of eye colour.