Cosmetic laser iridoplasty assessed by Catalan AQuAS

In early October 2019, the Health Evaluation and Quality Agency of Catalonia (AQuAS) published the assessment of cosmetic laser iridoplasty. This technique reduces the density of the brown pigment in the iris, to obtain a green or blue color permanently, unlike the opaque colored contact lenses. The procedure is used either for patient’s own wish (no physical condition), or to treat heterochromia.

AQuAS was given the task from the Catalan healthcare authorities to assess this procedure, more specifically, to assess its safety, efficacy, cost and ethical impact.

Five (5) studies have been included for this report: a single cohort study with 90 cases (180 eyes), one (1) series of seven cases (eight eyes), one (1) case study, one (1) study of 12 cases in rabbits and one (1) study in cadavers. None of these studies had follow-up time greater than two years. There is no evidence comparing iridoplasty and opaque contact lenses in clinical trials.

Conclusions:

• Regarding effectiveness, the change of the color of the iris is visible after 1-3 sessions. At least 1-2 more sessions are required to remove additional residual or new pigment
• The patient can choose the exact color they want, but the outcome cannot be guaranteed
• The most common adverse event is increased intraocular pressure, which is treated pharmacologically. Sensitivity to light and other minor complications occur in 2% of the cases
• The total cost of this technique is €2500-€4500, depending on the basic color of the iris
• Every second person who undergoes this procedure is not fully satisfied
• The risk-benefit ratio is still not well defined, because the outcomes are uncertain and potentially irreversible
• It is recommended to undergo this intervention exclusively within clinical investigation settings and after getting approval by the ethics committee

See the complete report in Catalan here.

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