• Ulku Dogan had surgery to make her eyes blue after wearing colored contact lenses for years.
• Keratopigmentation involves making a channel in the cornea and placing colored dye inside.
• The procedure has gained traction online but isn't FDA-approved.

For 20 years, Ulku Dogan, a wealth advisor in San Francisco, wore colored contact lenses because she longed to have blue eyes.

Seven weeks ago, her dream came true when she flew to New York and paid $12,000 for surgery to permanently change her eye color from brown to blue.

"I feel confident, very happy. It is the best investment I've ever done for myself," Dogan, 49, told Business Insider. "I wish I had done this 10 years ago."

To change her eye color, Dr. Kevin Niksarli, one of a handful of ophthalmic surgeons in the US to offer cosmetic keratopigmentation, used a laser to poke two holes in her corneas, the clear, outermost part of the eye. This creates a channel that sits atop the colored part of the eye, which is then filled with dye.

Niksarli has been performing corneal laser eye surgeries for 30 years and started offering the procedure to patients in 2023. At his clinic, Manhattan LASIK Center, patients can choose from 11 shades, including emerald green, lagoon, and honey.

First, he colored Dogan's left eye. He let her assess it and asked if she wanted to make any changes to the shade before moving on to the right eye.

"I'm like, 'Doctor, can you go a little brighter?' And then he went a little brighter, and I loved it," Dogan said.

Though keratopigmentation is not FDA-approved, interest in the procedure is growing. In a medical context, it's used to treat patients with iris loss, damage, or trauma. But TikTok videos showing before-and-after images of patients who've undergone the procedure for aesthetic reasons have racked up millions of views.

Dr. Alexander Movshovich, who in 2019 became the first doctor to offer the procedure cosmetically in the US, saw 15 patients in his first year, he told The Wall Street Journal. He's now performed the procedure over 750 times, he told Ophthalmology Times.

"This procedure is safe and that was proven in the peer review literature," Movshovich told BI in an email, noting that people with chronic eye diseases would need to have an individual consultation to assess whether they would be a good candidate.

The American Academy of Opthalmology warns against cosmetic eye treatments

The permanent procedure is painless and fast, said Dogan, who experienced no side effects other than discomfort on the first night and some light sensitivity for a few days.

Some doctors, however, argue that there isn't enough evidence that the benefits of cosmetic eye surgery outweigh the known and potential long-term risks.

In January, the American Academy of Ophthalmology warned that keratopigmentation could cause infections, light sensitivity, and damage to the cornea that could lead to cloudiness, warpage, fluid leakage, or vision loss.

"Patients contemplating these procedures for cosmetic reasons alone must weigh these serious risks against the potential gain," the AAO said.

In a 2021 study published in the Journal of Cornea and External Disease, 12 out of 40 keratopigmentation patients experienced light sensitivity in the first month. Five said the pigment faded or changed in color after 29 months, and one who had previously had Lasik, a type of vision-correction surgery, developed corneal ectasia, a condition that causes the cornea to thin and bulge outward. All of the participants said they were satisfied with the cosmetic results.

"Personally, if it were me, I would rather use colored contacts for a cosmetic benefit instead of putting myself at risk of long-term side effects that we don't even know because research hasn't even been able to go that far," Dr. Julian Prosia, a board-certified optometrist in Canada, said in a TikTok video.

In a letter sent to the AAO in July, Movshovich and three other ophthalmologists who provide or research the procedure said that many of the possible risks listed on the AAO warning "have never occurred with keratopigmentation" and are "not founded on fact."

The AAO told BI that it stands behind the evidence provided. "Everything in life has some degree of risk, including getting out of bed in the morning. The question is how common, severe or reversible are the adverse outcomes compared to potential benefits or alternatives. The calculus for medical/therapeutic applications is completely different from that for cosmetic procedures," Stephen D. McLeod, CEO of the AAO, told BI in an email.

Dogan was willing to take the risk

Dogan had looked into iris implant surgery, in which an artificial iris made of silicone is inserted into a slit cut into the cornea and adjusted to cover the natural iris. But the procedure wasn't offered in the US at the time, and she deemed it too risky. In January, the AAO warned against iris implant surgery, which it said could cause permanent damage, vision loss, and glaucoma.

She hadn't heard about keratopigmentation until a trusted friend who's a plastic surgeon had the procedure.

"He got his eye colored, and I'm like, 'What else do I need?'" Dogan said. "It's confirmed results." She quickly booked an appointment with his surgeon.

Although Dogan was aware of the potential risks of the surgery, she chose to go ahead and is pleased with her results.

"When people ask me now, 'Do you have contact lenses?' I can say, 'No, these are my eyes,'" she said.