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The Neoris technique
- What are the risks?
In around 30% of cases, patients experience dry eyes and are troubled by bright lights. These symptoms usually disappear after a few weeks, or a few months in some rare cases. Some eye pain has also been reported. Eyesight may be modified, particularly with near vision discomfort in patients close to the age of 40 or older: they will then need to use glasses for reading or close work. I
t may happen that the colour wears off after a few months or years, particularly after significant exposure to the sun: in that case, it can be touched up easily. While further complications cannot be ruled out, they have never actually been observed. Since the Neoris technique only affects the cornea, it is improbable that it could trigger glaucoma.
- Are there any contraindications for operations using the Neoris technique?
Generally speaking, the Neoris operation is carried out on healthy eyes. Patients with corneal disorders cannot undergo the operation. Patients who have undergone a corneal transplant or radial keratotomy cannot be operated on using the Neoris technique.
If you have keratoconus:
keratoconus is a progressive disease that gradually transforms the cornea into a cone shape. Some patients have this condition without being aware of it since it does not bother them and their vision is normal. Keratoconus is an absolute contraindication for refractive surgery (surgery that corrects visual defects). The Neoris technique has already been used on patients with keratoconus and this has not had an adverse effect on their condition. This does not mean that the disorder will not grow worse one day because of the Neoris operation. So if you have moderate keratoconus (your eyesight must be good without glasses or with your glasses or contact lenses) and you nonetheless wish to undergo a Neoris operation, you will need to sign an additional disclaimer indicating that you have understood that you have keratoconus and that the consequences of the Neoris operation on your eye suffering from keratoconus are unknown. To find out whether you have keratoconus, ask your ophthalmologist to carry out a corneal topography.
If you have undergone an operation using a refractive surgery technique:
Refractive surgery corrects visual defects.
There are 4 techniques used in refractive surgery:
Radial keratotomy: this constitutes an absolute contraindication for Neoris surgery.
PRK: this presents no problems whatsoever for Neoris surgery.
Lasik (or Ultralasik or Femtolasik)
Lasik and Smile may, in some cases, make the Neoris operation impossible. Indeed, in around 10% of cases, the tunnel in the cornea made by laser during the Neoris operation coincides with the cut made during refractive surgery. In this case, the operation is impossible since the pigment would not remain within the tunnel, but would cover the centre of the cornea, thereby generating severe visual disorders. Unfortunately, it is impossible to tell in advance whether this problem will occur or not. It is during the surgical procedure, before the pigment is injected that we will be able to see whether the operation can be conducted or not. If the operation is not possible, surgery is interrupted without any complications for the patient and the amount of the operation is fully reimbursed.
Specific case of treatment for glaucoma: This treatment is not an absolute contraindication for Neoris surgery. However, you should be aware that certain examinations will be more difficult to conduct afterwards (e.g. the iridocorneal angle examination). An iridotomy using YAG laser in the event of acute glaucoma will also be more difficult after Neoris surgery, and the long-term effects of the treatment on the pigment and vice versa are unknown (Will the pigment weaken the effect of the treatment for glaucoma? Will the treatment affect the pigment?). This is why we currently prefer not to operate on patients who are being treated for glaucoma.
The specific case of cataracts: the Neoris operation leaves a central opening (a “pupil”) of about 5 mm. This opening provides sufficient visibility for a surgeon to perform a cataract operation should this prove necessary at some time during your life. However, we advise all patients over the age of 55 who are interested in Neoris surgery to consult their eye specialist for a cataract examination. And, if necessary, to have the cataract operation before Neoris surgery. (The cataract operation is more difficult to perform after the Neoris operation than before it). You must wait at least 3 months after the cataract operation before going for Neoris surgery.
Specific case of an eye that has already been operated on for a BrightOcular implant: First of all, these implants must be removed as rapidly as possible as they are very dangerous for your eyesight. If the cornea is healthy 3 months after the operation (in particular, the endothelial cell count is higher than 1500/mm2), then a Neoris operation can be envisaged.
Specific case of an eye that has been treated by laser depigmentation: no contraindication.
- Is night vision affected?
Since keratopigmentation makes part of the cornea more opaque, it is theoretically possible that your vision might be perturbed at night when the pupil dilates. But, if it does occur, it is barely noticeable and is no worse than driving at night with coloured contact lenses. This type of contact lens has been around since the 1990s and has never been considered as being a hazard for night vision.
- Why does the pupil not move anymore after the operation?
The real pupil continues to work normally, but it is less visible and is located behind the false motionless pupil created by the surgery.
- Why does the colour not cover the iris up to the centre of the eye?
The cornea is a transparent dome-shaped tissue that lies in front of the eye and that lets the light through to the retina. Making the edges of the cornea more or less opaque by inserting the pigment to it has no effect on the eyesight. However, pigmenting the centre of the cornea would severely limit the field of vision.
In addition, it would be more difficult for an ophthalmologist to properly examine the back of the eye, and some operations (such as cataract surgery) would also be difficult to perform.
- Is the Neoris operation the same as having an eye tattoo?
No, it’s not the same thing. An eye tattoo involves injecting pigments into the white of the eye (between the conjunctiva and the sclera). The injection is performed with a needle by a tattoo artist who is not a medical doctor. The risks involved in eye tattooing are considerable and serious complications have been reported.
On the contrary, the Neoris operation involves introducing a pigment into the cornea using laser, without any needles. The two procedures are completely different.
- Can you operate on dark eyes?
Yes. The result is actually better for dark eyes (grade 4 and 5) than for light eyes.
- Is the procedure painless?
The procedure is performed under a local anaesthetic administered through simple eye drops. The
surgery is not painful.
The patients may experience tingling or dryness in the eyes days or weeks after the procedure, but these symptoms are normal and disappear rapidly.
- Do you feel any pain after the operation?
Generally speaking there is little discomfort after the operation, but 20-30% of patients feel severe pain for 24 hours after the operation. In this case, you simply need to take the pain killers prescribed.
- Will I be able to see immediately after the operation?
Your vision tends to be blurred for a few hours after the operation, but you can nonetheless see sufficiently clearly to move about on your own and take a taxi. The following morning, your eyesight will be much better. It returns to normal after a few days.
- Is it possible to have the operation on one eye only or have two differently coloured eyes?
For ethical and aesthetic reasons, we only perform operations on both eyes and with the same colour.
- Is it possible to mix 2 colours (or more than 2 colours)?
Yes, it can be done. However, the result won’t be a patchwork of colours, but a single shade resulting from a mix of colours. Furthermore, there is a surcharge of €1500 per extra bottle of colour.
- Can the colour be removed?
It is possible to remove about 20-30% of the colour. A little colour remains, mostly close to the limbal ring and near the pupil.
- Is it possible to make the colour more or less intense?
Yes, this can be done by dosing the pigment density (or concentration). A low density will give you a natural look, but will be darker and less visible. A high density will give a more visible and lighter look, but will be less natural.
- What is the difference between colour density (concentration) and dilution?
They are opposites. The more colour there is, the higher the density and the lower the dilution.
- Does the eye colour look natural after the operation?
From very close and under intense lighting, an attentive person will be able to see that the colour of the eyes has been retouched. From about 50 cm away and under moderate lighting, the eye appears natural. In the evening and by a low light the colouring is less visible.
- Is it possible to reproduce the striped aspect of the iris?
No, that is not possible.
- How long does the change of eye colour last?
It is possible that the colour fades after a couple of months or years, especially if exposed to strong sunlight. In such cases a retouch is possible.
- Can you have a brain scan by MRI after the operation?
There’s no problem for the blue and green pigments as they don’t contain iron.
Brown pigments contain a very small amount of iron which could lead to a sensation of heat for the eye, but this is harmless.
- How quickly can I get back to normal life after the operation?
Within just 3 days, you can do all your normal activities such as sport, putting on makeup etc.
- Is it possible to make the eye bigger, like with coloured contact lenses?
No, that is not possible.
- Is it possible to operate on an eye that already has a BrightOcular implant?
First of all, these implants must be removed as rapidly as possible as they are very dangerous for your eyesight. If the cornea is healthy 3 months after the operation (in particular, the endothelial cell count is higher than 1500/mm2), then a Neoris operation can be envisaged.
- Is it possible to operate on an eye that has been treated by laser depigmentation?
Yes, it is possible.
- What are the ingredients of the dye?
The pigment used by Neoris is made in France. The dispersion consists of a natural vegetable
equivalent of propylene glycol and of PH modifiers (lactic acid or Na-hydroxide depending on the
The pigments consist of a mixture of:
- iron oxides (yellow + red + black) and titanium for a brown colour,
- chromium oxides, ultramarine and titanium dioxide for a green colour,
- Ultramarine, copper phthalocyanine and titanium dioxide for a blue colour,
- black iron oxide and carbon for a black colour.
- Can myopia be operated in the same procedure?
If you also wish to undergo refractive surgery (myopia operation, astigmatism operation, hypermetropia operation or presbyopia operation), you must carry out a topography eye test with your ophthalmologist before your Neoris operation.
- If the topography eye test is normal, then you should start by changing the colour of your eyes and then undergo the refractive surgery, waiting at least 3 months after the Neoris operation.
- If keratoconus is detected during the topography eye test and laser surgery is impossible, you should firstly undergo refractive surgery with the insertion of an implant and then go for the Neoris operation at least 3 months after the refractive surgery.
- What is the limbal ring?
The limbal ring is the dark circle on the edge of the cornea. It intensifies your gaze and makes you look more attractive.
The Neoris technique can create a thicker or thinner ring around the iris.
- Are there alternatives to Neoris?
There are several alternatives to Neoris, such as:
- wearing coloured lenses:
This is by far the most frequently used method. However, it should be noted that the complications associated with wearing coloured lenses are more frequent than the complications related to wearing transparent lenses.
- incorporation of coloured silicone implants into the eye:
This technique regularly causes complications that can be very serious. Several cases of blindness have been described following the placement of these implants.
- laser depigmentation of the iris:
This method has an extremely low success rate. Only 10% of patients are satisfied with the results:
- The result is visible only after many laser sessions and most often the final colour tends to be a faded gray. It is impossible to choose a colour
- This technique does not work with highly pigmented eyes (grade 4 and 5).
- A repigmentation is common after 1 year.
- In addition, serious complications such as glaucoma, are possible.
Unlike all these alternative techniques, keratopigmentation developed by Dr. Ferrari and promoted by Neoris has recorded excellent results. Practised since 2013, this method has already proved itself over time.
Keratopigmentation, which is offered exclusively by Neoris, is the only surgical technique that can change eye colour permanently and safely. The opthalmic surgeons, members of the Neoris Alliance who are eligible to practice keratopigmentation, are carefully trained by the inventor of this technique. They are obligated to follow a special medical protocol and have a compulsory insurance in order to be allowed to perform this unique procedure.
- wearing coloured lenses:
- At what minimum age can I undergo the surgery?
The minimum age is 21 years old.
- Where can I undergo the surgery?
The procedure takes place only in ophthalmic surgery clinics scrupulously selected by Neoris on the basis of the quality of their technical equipment.
Clinic “Espace Nouvelle Vision”
6 rue de la grande chaumière, 75006 Paris, France
The interventions take place on Tuesdays and Wednesdays.
It is advisable to arrive in Paris on the evening preceding the intervention.
The morning will be devoted to a series of ophthalmic exams carried out in order to confirm the information gathered by the doctor during the first consultation. Once this is done, the surgeon will see you for a further consultation. The surgery will take place on the afternoon.
A postoperative check-up will take place on Friday morning, the day after the procedure.
A second check-up takes place 3 months after the intervention.
- Are there any special requirements prior to the operation?
At the first meeting organized by Neoris you will discuss the procedure with the surgeon who will operate on you. He will tell you about all the risks that are inherent to this intervention and you will be asked to report your medical history. This first contact between the patient and the practitioner is essential and mandatory before any intervention. This meeting can take place in person or via a video conference at least 15 days before the intervention.
- Will my identity documents still be valid after the operation?
No, because your appearance will have changed. Therefore, it will be necessary to renew your identity documents after the operation.