CAIRS - Corneal Allogenic
Intrastromal Ring Segment Surgery

About

CAIRS (Corneal Allogenic Intrastromal Ring Segment) is an advanced and minimally invasive surgical procedure designed to treat keratoconus and other corneal ectatic disorders. Ectatic disorders of the cornea include keratoconus, Post-LASIK ectasia and pellucid marginal degeneration.

These conditions often lead to a progressive thinning and bulging of the cornea, resulting in distorted vision and other visual impairments. CAIRS involves the insertion of ring segments made from donor corneal tissue to reshape and stabilise the cornea, which may help improve vision and reduce symptoms.
If you are experiencing symptoms of keratoconus or other corneal issues, contact Vision Clinic Sydney for more information on CAIRS surgery in Sydney.

What is CAIRS?

CAIRS, or Corneal Allogenic Intrastromal Ring Segment, is a procedure where shaped corneal segments from donor corneal tissue are implanted into the cornea, using channels created by a femtosecond laser.

These intracorneal ring segments aim to reshape and stabilise the cornea, potentially improving vision and helping to manage the progression of corneal ectatic disorders such as keratoconus.

By modifying the corneal stroma, CAIRS may enhance corrected visual acuity and overall visual outcomes.

Conditions Treated by CAIRS

Keratoconus and other corneal ectatic disorders are the primary conditions treated by CAIRS.
Keratoconus is a progressive eye disorder where the cornea, which is normally round, thins out and bulges into a cone-like shape. This abnormal shape deflects light as it enters the eye, causing distorted vision.

Keratoconus usually starts during adolescence or early adulthood and can progress over several years. Early symptoms may include:
Blurred or distorted vision: As the cornea becomes more irregular in shape, it leads to visual distortion.

Increased sensitivity to light and glare: Patients may find it difficult to see in bright light.
Frequent changes in eyeglass prescriptions: Vision can rapidly change, requiring frequent updates to corrective lenses.
Difficulty seeing at night: Night vision can become particularly challenging.
Double vision in one eye: This occurs when the irregular shape of the cornea causes light to be focused unevenly.

Other Corneal Ectatic Disorders
In addition to keratoconus, CAIRS can potentially treat other corneal ectatic disorders, such as:

Pellucid Marginal Degeneration (PMD): This condition causes the lower part of the cornea to thin, leading to a similar bulging and vision distortion as keratoconus.
Post-LASIK Ectasia: A complication that can occur after LASIK or SMILE surgery, where the cornea becomes progressively thin and unstable.

What Causes These Conditions?

These conditions can develop due to a combination of genetic, environmental, and behavioural factors, including:
Genetic predisposition: Inherited genetic factors can make individuals more susceptible to these conditions.

Chronic eye rubbing: Repeatedly rubbing the eyes can weaken the corneal structure, leading to ectasia.
Environmental factors: Exposure to ultraviolet (UV) light and allergens can contribute to the development of keratoconus.
Systemic conditions: Conditions such as connective tissue disorders can affect the integrity of the cornea.

The Benefits of CAIRS surgery

The CAIRS procedure may offer several significant benefits:

Minimally invasive: The procedure involves small incisions and a short recovery time, potentially minimising disruption to daily life.
Vision improvement: It aims to to improve the quality of vision by reshaping the cornea, potentially enhancing visual acuity.
Delay or avoidance of corneal transplant: CAIRS may delay or eliminate the need for more invasive corneal transplantation procedures.
Enhanced comfort: May reduce the need for rigid contact lenses, potentially providing greater comfort and convenience.

It is important to note that while CAIRS has shown promising results for many patients, individual outcomes may vary. A thorough consultation with a cornea specialist is necessary to determine if this procedure is suitable for your specific condition.

Risks of CAIRS surgery

As with any surgical procedure, CAIRS carries certain risks, including:
Infection: Although rare, infection can occur post-surgery, requiring prompt treatment.

Displacement: The intracorneal ring segments may move and require repositioning or adjustment.
Visual disturbances: Some patients may experience glare or halos, particularly at night, which can affect visual outcomes.
Over or under-correction: The procedure might not achieve the desired level of vision correction, necessitating further treatments or adjustments.

How do I Know if This Procedure is Right For Me?

CAIRS may be the right choice for you if:

You have been diagnosed with keratoconus or another corneal ectatic disorder.
Non-surgical treatments such as contact lenses and corneal cross linking have not provided adequate relief.
You seek a less invasive alternative to corneal transplantation.
You are experiencing progressive visual deterioration that impacts your quality of life and corrected visual acuity.

How is CAIRS Performed?

The CAIRS procedure involves several precise steps, each aimed at ensuring the optimal integration of the allogenic tissue ring segments into the patient’s cornea:

Preparation: Local anaesthesia is administered to numb the eye, ensuring a comfortable procedure. This step is crucial to minimise any discomfort for the patient during the creation of channels in the host cornea.
Channel Creation: A femtosecond laser or a mechanical device creates channels within the corneal stroma.
These channels are specifically designed to accommodate the CAIRS segments, considering the inner diameter and placement to reshape the cornea effectively. This process is carefully monitored using corneal topography to ensure precision.
Insertion: The corneal ring segments, crafted from donor cornea or modified corneal tissue grafts, are inserted into the prepared channels. These CAIRS segments are processed and shaped before implantation, not simply raw donor tissue. They help to reshape the cornea, improving its spherical equivalent and stabilising its structure.
Unlike synthetic segments, the use of allogenic tissue ring segments aims to integrate naturally with the patient’s cornea, reducing the risk of complications such as anterior stromal necrosis.
Post-Procedure Care: Patients receive antibiotic and anti-inflammatory eye drops to prevent infection and facilitate healing, ensuring the best visual outcomes.
Regular follow-up appointments are scheduled to monitor the integration of the segments and the overall health of the corneal transplants.

This meticulous process not only helps potentially in correcting corneal disorders but also provides an alternative to a more invasive traditional and more invasive corneal transplant, offering significant improvements in vision and quality of life for patients.

CAIRS Surgery Cost - Sydney

The cost of CAIRS surgery varies depending on individual circumstances and specific requirements. A full consultation is necessary to determine the exact cost. Please contact Vision Clinic Sydney to schedule your consultation and receive a personalised quote.

Choose Vision Clinic for Your CAIRS Surgery

Vision Clinic Sydney is dedicated to providing exceptional eye care services, including CAIRS surgery. We offer comprehensive eye examinations to determine the best treatment plan for your condition, ensuring optimal results and patient satisfaction.

Meet Dr. Nikhil Kumar

Dr. Nikhil Kumar’s passion for ophthalmology is driven by his admiration for the complexities of the eye. He graduated with a degree in Medicine from the University of Newcastle in 1998 and completed his specialised training in ophthalmology at the Sydney Eye Hospital in 2008. With further subspecialist cornea training, Dr. Kumar has performed thousands of surgeries, including cataract surgery, refractive surgery (laser vision correction), corneal transplantation, pterygium surgery, keratoconus management using transepithelial collagen cross-linking, topography guided PTK, and CAIRS.

Areas of expertise:

How to book an appointment

For the initial visit, you will need to provide a referral letter from your primary care physician or eye specialist in order to qualify for a Medicare rebate for the consultation and any tests/procedures done at the clinic.

If you do not have a referral letter, you can still be seen at the practice, but you will not be able to claim a Medicare rebate.

You can download the referral PDF form or submit it online.

Please bring:

Any prescription glasses that you wear
Sunglasses or a hat as your eyes may be dilated during the consultation, resulting in possible sensitivity to light and blurred vision. You may not be able to read or drive for 4 hours after your appointment.
A list of current medications and details of your medical history
Your Medicare card, private health fund card and pension card if you have them.

Our location in Sydney

We are located in the central business district of Sydney in New South Wales. Our physical address is Level 6, Suite 605, 229 Macquarie St., Sydney NSW 2000, Australia.

FAQs

Below you can find our most frequently asked questions:

What is the recovery time for CAIRS?

Most patients can resume normal activities within a few days, though complete healing may take several weeks. It is essential to follow post-operative care instructions and attend follow-up appointments to monitor progress and ensure optimal visual outcomes.

Will I need to wear glasses or contact lenses after CAIRS?

While many patients experience significant vision improvement, some may still require glasses or contact lenses for best corrected visual acuity. The need for corrective eyewear often depends on the extent of the corneal condition and individual response to the surgery.

Are the results of CAIRS permanent?

CAIRS provides long-lasting results by stabilising the corneal shape. However, periodic monitoring and follow-up appointments are crucial to ensure the ongoing stability and health of the cornea. In some cases, additional treatments such as corneal cross linking may be necessary to maintain the results.

Can CAIRS be combined with other treatments?

Yes, CAIRS can be combined with other treatments, such as corneal cross linking, to enhance outcomes. Your ophthalmologist will recommend the best combination of treatments based on your specific condition and needs, aiming to improve visual acuity and overall visual outcomes.

What are the signs that I need CAIRS surgery?

Signs that you may need CAIRS surgery include progressive worsening of vision, difficulty with contact lenses, significant corneal thinning, and irregularity. If non-surgical treatments are no longer effective, CAIRS might be a viable option.

How does CAIRS compare to a traditional corneal transplant?

CAIRS is a less invasive alternative to a traditional corneal transplant, involving the insertion of allogenic tissue ring segments into the patient’s cornea rather than replacing the entire cornea. This can result in a quicker recovery and lower risk of complications. However, for severe cases, a traditional corneal transplant might still be necessary.

What precautions should I take after CAIRS surgery?

After CAIRS surgery, it’s crucial to avoid rubbing your eyes and engaging in strenuous activities for a few weeks. Follow your ophthalmologist’s instructions regarding medication and attend all scheduled follow-up appointments to monitor the healing process and ensure the ring segments are properly integrated into the host cornea.

General Information Disclaimer: The content provided here is for informational purposes only and is not intended as medical advice, diagnosis, or treatment. Always seek the advice of your health professional with any questions you may have regarding a medical condition. The information on this site is general in nature and may not reflect current medical developments or research. Your reliance on any information provided by this site is solely at your own risk.

Pterygium Excision with Conjunctival Auto-grafting

In this procedure, the pterygium is removed along with the tissue covering the sclera (conjunctiva). Tissue is removed from the patient’s upper conjunctiva and used to cover the bare sclera. Dr. Kumar advocates the use of fibrin glue rather than sutures to fix the autoconjunctival graft into place.

Concerned About Your Vision?
We can help.