Cosmetic Keratopigmentation Works and Can Be Used as a New Aesthetic Solution to Change the Apparent Color of the Eye

Keratopigmentation has re-emerged as a corneal surgical technique with therapeutic, functional, and cosmetic applications. Advances in micronized mineral pigments and femtosecond-assisted approaches have expanded its indications from disfigured eyes and selected functional disorders to elective eye color change. Reported short-term outcomes have generally been favorable, with high patient satisfaction in selected cases. However, wider adoption remains limited by the lack of long-term evidence, particularly for cosmetic indications, and by concerns regarding pigment standardization, safety, stability, tolerance, and durability. Cosmetic keratopigmentation also raises ethical and professional considerations and should be undertaken with careful patient selection, appropriate surgical training, and controlled clinical evaluation. Further guideline development and high-quality long-term studies are needed to better define its role in contemporary corneal practice.