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CAIRS

CAIRS (Corneal Allogeneic Intrastromal Ring Segment) is a revolutionary new treatment for advanced keratoconus that is now available at all leading keratoconus centres around the world. Nick Maycock at LaserVision in Portsmouth is the only clinic in Hampshire, Dorset and Wilshire to offer this game-changing procedure.

Traditionally, the treatment of keratoconus has relied upon stabilisation of the cornea with corneal collagen cross-linking followed by visual rehabilitation with glasses or contact lenses. More advanced disease requiring surgery to reshape the cornea with INTACS (PMMA intracorneal ring segments), topographic-guided laser and corneal graft surgery (DALK or penetrating keratoplasty).

CAIRS involves the implantation of small strips of donor human cornea within the keratoconic cornea. This has three significant benefits: firstly, it adds extra human corneal tissue to a cornea that has been thinned by the keratoconus disease process, secondly, it produces a significant flattening of the central cornea, reducing irregular astigmatism providing a significant improvement in vision as early as day one, and thirdly it further reduces the need for corneal graft surgery. The procedure can be done either before or after corneal collagen cross-linking. Donor human corneal tissue is the optimal implant as it becomes assimilated into the cornea with less risk of rejection, pain and other complications associated with PMMA rings such as INTACS or AJL rings. CAIRS is also more customisable than standard PMMA rings producing a greater corneal flattening. CAIRS can be part of a multi-stage treatment plan including topographic laser and implantable collamer lens (IPCL / ICL) to offer patients the best achievable vision.

Using the Ziemer Z8 femtosecond laser, a precise intrastromal channel is made within the corneal stroma and a precut segment of human donor cornea inserted. This allows very accurate placement of the donor strip within the cornea and the axis, location and size of the channel can be specifically tailored to each patient to optimise visual outcomes. CAIRS donor cornea implants are available precut (www.keranatural.org) or can be made bespoke using our Ziemer Z8 laser.

Please get in touch to find out more about this game-changing treatment.

Nick Maycock - Anterion AS OCT

Anterion AS-OCT image showing the CAIRS ring within the corneal stroma.

Nick Maycock - Anterion difference map

Anterion difference map showing the corneal flattening at day 1 postop.

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CAIRS

At a glance

Treatment

Frequently asked questions

The procedure is carried out under topical anaesthetic eye drops. The vision goes very blurry for around 20-30 seconds while the Z8 femtosecond laser creates the pocket in the cornea. The donor cornea implant is then placed into the cornea. The procedure usually lasts 15-20 minutes.

The procedure is painless due to the application of topical anaesthetic drops. The eye may feel gritty and scratchy for the first day after surgery as the surface heals. There is minimal discomfort / pain during the recovery period and most patients can be back to normal activities within a few days.

Some patients notice a significant improvement in vision as early as day one following surgery, but it depends on the severity of the keratoconus before the procedure. The effect of the CAIRS implant on the cornea and vision will have stabilised by 3 months following surgery.

Yes. The procedure can be done after crosslinking although the effect may be less due to the cornea being stiffer.

CAIRS can be carried out as part of a multi-stage procedure including corneal cross-linking, topography-guided corneal laser and / or implantable contact lens to optimise the vision.

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Keratoconus is a non-inflammatory eye condition that can causes the cornea to thin and form a cone shape.

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