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Eyes on the Prize

A new laser system may make brown eyes blue.

With Julie Woodward, MD
 

Although it was previously thought to be impossible, cutting edge laser technology research is showing promise that a laser can safely—and permanently—change the color of a person’s eye from brown to blue, green, or hazel.

Underneath the brown pigment of every brown eye is a blue or green iris. In the past, ophthalmologists around the world have tried to use a laser to lyse the thin layer of brown pigment cells to expose the underlying blue or green. Unfortunately, this resulted in the cells containing brown pigment to be dispersed only to land on the trabecular meshwork fluid drainage system of the eye, causing a blockage and subsequent rise in intraocular pressure (IOP), resulting in glaucoma.

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The new technology by Stro–ma Medical Corporation involves a laser system that slowly and repeatedly heats the cells instead of lysing them. This allows them to be slowly absorbed by the body’s macrophages through the iris vascular system, instead of dispersing them around the eye. So far clinical trials have involved a 1/8 sector of the iris with success in revealing a blue hue one month post-operatively. To date, no increase in intraocular pressure has been noted in any test subjects. In fact, the majority of patients noted a decrease of IOP. So far, all clinical trials have been conducted overseas, primarily in Central America.

During the procedure, the pupil is constricted to just 1-2mm with pilocarpine. Stro–ma, in its commitment to safety, has avoided treatments near the pupil margin to avoid laser rays entering the posterior chamber of the eye.

As with any aesthetic procedure, predictability and adjustability of outcomes is important. Iris color is composed of hue (blue or green), saturation (proximity of the hue to light gray), and value (degree of light reflectance). Iris hue is generally predictable. Based on the prevalence of blue and green eyes in the overall population, a Stro–ma patient will have an 89 percent chance of achieving blue eyes and an 11 percent chance of achieving green eyes. For even greater predictability, however, Stro–ma has developed a separate technology capable of identifying the underlying hue in advance.

Iris saturation and value are both predictable and adjustable. The procedure requires only a single treatment, and the result of that treatment will be of low saturation and high value, which is generally the most highly desired outcome. Stro–ma has developed an additional setting to increase saturation after the initial results are revealed.

The price tag on the laser is expected to be about $350,000 with suggested retail list prices for patients being $5,000-$7,000 for the basic hue treatment. I look forward to the evolving developments of this new aesthetic technology.

Julie Ann Woodward, MD is a Professor of Ophthalmology and Chief of Oculoplastics Ophthalmology and a Professor in Dermatology at Duke University School of Medicine in Durham, NC.

This article is based on a presentation given at Cosmetic Surgery Forum 2017. Cosmetic Surgery Forum 2018 will be held November 28 to December 1 at Cosmopolitan, Las Vegas. For information, visit CosmeticSurgeryForum.com.

 

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About Practical Dermatology

Practical Dermatology is the monthly publication that provides coverage of medical care, cosmetic advancements, and practice management for clinicians in the field. With straight-forward, how-to advice from experts in various fields, we strive to enhance quality of care and improve the daily operation of dermatology practices.