These 2 cases add to a growing body of literature regarding profound anterior segment damage, including uveitis, glaucoma, and corneal decompensation, secondary to NewColorIris implantation.2 While not approved by the US Food and Drug Administration for implantation in the United States, the NewColorIris poses a very real risk to patients willing to travel abroad to have it implanted. As we have demonstrated by anterior segment OCT and light and scanning electron microscopy, the NewColorIris device has intraocular positioning and surface characteristics that likely contribute to its poor tolerance in the anterior chamber of some patients. Specifically, if the device is undersized relative to the anterior chamber, it may not sit properly and can then contact the corneal endothelium (as in case 1). Alternatively, it can cause direct damage to angle structures in those with less generously sized anterior segments, which can lead to glaucomatous angle changes such as synechiae. This was particularly evident in case 2, in which profound angle damage was inflicted in the setting of an implant that was shown by OCT to be directly apposing the angle structures prior to its explantation. It is our feeling that the surface characteristics of the implant, particularly its relative surface irregularity compared with other better-tolerated anterior segment implants, were responsible for significant ocular inflammation in both patients in this series. The medical literature demonstrates that inappropriately sized anterior chamber implants deleteriously affect corneal endothelial cell counts and angle structures, as shown in the analysis of phakic intraocular lens tolerance.3 Although implant design and positioning issues strongly influenced these outcomes, the biocompatibility of the material and chemical coloring of the NewColorIris device may have also contributed to these complications; however, we were unable to confirm this.