The artificial iris is made of silicone. German artisans refer to a photograph of a patient's good eye and paint an exact replica onto the flexible silicone wafer. Then they encase that artificial iris in more silicone so the pigments don't leach out.
The device is not in clinical trials or even approved for use in the U.S., so Miller applied for a "compassionate use" exemption from the Food and Drug Administration, a process which took three months. It took another six weeks for the company to manufacture and ship three versions of the painted silicone wafer: one a perfect match to his left eye and two others which were darker and lighter. Cost of the device: more than $5,000.
Haverstick does not have health insurance and is relying on family and friends to help pay for the procedure. The transplant itself cost about $8,000. Typically, insurance plans do not cover devices which are not FDA approved.
The surgery itself took less than an hour. Miller made an incision into the cornea – the clear part of the front of the eye -- rolled up the flexible wafer like a cigar and inserted it, then unrolled it flat.
Unlike a normal iris whose pupil adjusts to different levels of light, the artificial iris has a fixed diameter.
"It's not the six million dollar man," said Miller. "It's not bionic and it doesn't open and close. But I think it's going to be a huge evolution in the treatment of patients with missing iris tissue."
At his post-op appointment the next day, Miller removed the large patch over Haverstick's right eye.
"It's a really nice color match," said Miller, who led his patient over to the mirror to see for himself.
"Wow," said Haverstick. "You know when I first had the injury I would stare at the mirror like this and think my eye was working, but it wasn't."
He looked at Miller with eyes that were the same color for the first time in 27 years. "That is really a good job. Thank you."
Haverstick turned around to show his mother and sister, who were both wiping away tears.
"You can't tell it's not a real iris," said his sister Susan Haverstick. "It looks exactly like the other iris. It's gorgeous. I'm really happy for him."
After a second post-op appointment in about a week, Haverstick will return to his family in Oklahoma. He has three daughters. The oldest was two when her father was injured; the others were not even born. They have always remembered him with two different colored eyes.
"I can't wait to get home and show them," said Haverstick.
Miller will be speaking with ophthalmology colleagues to begin clinical trials with the custom artificial iris device and hopes to get FDA approval within 5-6 years.
"People are always looking to change cosmetic appearance," said Miller. "I don't think this is a procedure to change eye color. This a baby step in the direction of helping people with a significant medical problem. You never know what the cosmetic ramifications will be as time goes on."