The purpose of this review was to evaluate the postoperative results of cosmetic iris implants. A systematic review of studies reporting postoperative outcomes of cosmetic iris implants identified 26 studies and 3 videos, comprising 128 eyes. In 88 (68.8%) of the eyes, the device required explantation due to complications. Secondary glaucoma occurred in 59 eyes, uveitis in 39 eyes, cataract in 22 eyes, and severe endothelial cell loss or corneal decompensation in 44 eyes. In 8 eyes, the final corrected distance visual acuity was counting fingers or worse. The review showed that cosmetic iris implants resulted in a substantial number of cases with severe complications. The finding strongly suggests that this cosmetic surgical technique should be avoided. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned.