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Featuring my fellow resident & friend, Dr A. Aziria for the narration. This patient was referred by her general ophthalmologist for severe ocular hypertension and endothelial cell loss caused by an artificial colored-iris implant. An eye surgeon performed a colored-iris implantation 5 years ago in Tunisia because she wanted to change the color of her eyes. These complications require immediate explantation of the device. Pre-operative investigations showed that almost 70% and 80% of her vision was already lost at her right and left eye, respectively. This device has five anchoring protrusions that may adhere to iris tissue. Break these adhesions by injecting viscoelastic between the cosmetic and the natural iris. To remove the device, use Chang IOL Cutter scissors with straight shaft to make two partial-thickness incisions at the inferior part of the device to create a tab opposite the corneal entry. Use a gonioprism to check the presence of peripheral anterior synechiae that may have formed in the trabecular angle and attempt viscodissection if so. Patients implanted with cosmetic iris devices are often reluctant to have them removed when they are asymptomatic. Often, they delay removal until they experienced significant pain or vision loss. Once these symptoms develop, they already have permanent ocular damage. These cosmetic implants are illegal in many countries as their complications rate is very high. These cosmetic iris implants cause chronic ocular inflammation, angle-closure glaucoma, cataracts and corneal decompensation. A significant number of eyes suffered permanent structural damage or visual impairment as a result of cosmetic iris implantation. Cosmetic implants such as the BrightOcular or the NewColorIris iris devices are currently available and are widely promoted on various Internet channels, including YouTube. These devices are not licensed for use in the United States or the European Union. Instead, residents of those countries typically travel elsewhere for surgery. These cosmetic devices represent a major public safety concern. Warn your patients against these cosmetic artificial iris implants. #artificialirisexplantation #colorediris #brightocular #newcoloriris #cosmeticiris #awareness #eyecolorchange #artificialiris #eyesurgery #ophthalmology #eyesurgeon #plasticsurgery #surgeon #aesthetic #eyecolor #blueeyes #greeneyes #browneyes #color