Keratoconus vision correction with Femto-CAIRS
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- Keratoconus vision correction with Femto-CAIRS
In 2016, Dr. Soosan Jacob from India developed Corneal Allogenic Intrastromal Ring Segments (CAIRS). This method utilizes segments created from human donor cornea tissue, aiming to reduce the complications associated with PMMA. The creation of the tunnel, however, was still performed manually, which can be challenging in very thin keratoocnus corneas.
The CAIRS technique was further refined by Professor Shady Awwad from Lebanon, where he enhanced the CAIRS procedure by utilizing femtosecond laser technologyto precisely prepare the ring segment from donor human cornea tissue. He also used the same femtosecond laser to create the tunnel in a pre-determined region of the patient’s cornea to implant these ring segment. This procedure was named “All Femto-CAIRS.”
The key advantage of employing a femtosecond laser lies in its capacity for precise customization of the allogenic ring segments and their strategic placement within the cornea of the keratoconus patient. The femtosecond laser enables the tunnels to be placed accurately in deeper parts of the cornea, and since the ring segment now is made from the same material (human cornea) , the risk of migration isis eliminated.
Creation of the CAIRS segments with the femtosecond laser
Our surgeons from the ELZA Institute were the first in Switzerland and among the first in the world to perform the All Femto-CAIRS procedure.
They have seen very positive effects on corneal shape and patient vision to date, with a noted capability of placing allogenic rings precisely into the best depth of the stroma when compared to PMMA rings, potentially offering a more effective corneal shape correction.
No. In the contrary: the implanted corneal ring segment adds additional tissue to your cornea.
Candidates for CAIRS typically have corneal steepness between 50 and 70 diopters and a minimum stromal thickness of 300 micrometers. The expected outcome is a flattening of the cornea by five to more than ten diopters. The procedure also allows for the possibility of further corneal improvements through additional treatments, such as ELZA-PACE (ELZA’s own customized cross-linking) or wavefront-guided transPRK.
Yes. Whether your cornea is progressive or stable is an issue that will be addressed with corneal cross-linking (CXL).
Femto-CAIRS has a different effect, it reshapes the cornea for better vision. Femto-CAIRS can be used in both stable or progressive keratoconus. In the latter, it will be combined with CXL.
All Femto-CAIRS represents an approach in corneal treatment that combines the use of human corneal tissue with laser technology, aimed at addressing corneal irregularities with a focus on both safety and customization to each patient’s cornea.
The beauty of All Femto-CAIRS is that it adds additional tissue to the thin keratoconus cornea. In a next step, the cornea and the patient’s vision can be further improved with other treatments, such as ELZA-PACE and/or wavefront-guided PRK.
The price of Femto-CAIRS depends on several factors, including the individual staging of the patient’s disease and whether one or two ring segments are necessary.
Femto-CAIRS is a complex procedure and involves detailed planning of the placement, length, and width of the ring segment, the preparation of the ring segment from a human donor cornea provided by an eye bank, the planning, calculation, positioning and creation of the corneal tunnel in the patient’s cornea, and implantation of the ring segment under intraoperative control of an optical coherence tomographer (OCT)
The total treatment time including calculation of the profile can take up to 3 hours for the surgeon and his team. All these factors and the additional cost of a human cornea provided by an eye bank make the procedure considerably more costly than a ring implantation with a PMMA plastic ring segment.
