Cosmetic iris implants (not yet FDA-approved or CE-marked) lead to severe loss of visual function in many cases, and their implantation should be considered malpractice.

Laser iris depigmentation represents a promising new surgical approach to change eye color but still lacks strong evidence about outcomes and complications in the short and medium term.

Femtosecond-assisted cosmetic keratopigmentation is the most widely studied technique to accomplish cosmetic eye color change by injecting mineral micronized pigments inside a stromal pocket. Medium- and long-term evidence is available for this technique.