When Does Vision Improve After CAIRS?

Although the recovery process varies from patient to patient, a noticeable improvement in visual acuity usually begins within the first few weeks and continues over the following months. During this period, the best outcome is targeted with regular check-ups and, when necessary, lens fitting.

Is CAIRS Performed Together with Cross-Linking?

Yes. To stop the progression of the disease, the CAIRS procedure is often planned together with Cross-Linking (corneal collagen cross-linking). This combination aims both to correct the shape of the cornea and to halt the progression of the disease.

What Is the Difference Between CAIRS and a Corneal Transplant?

In a corneal transplant, the patient's cornea is completely or partially replaced. With CAIRS, only thin natural ring segments are placed into the cornea, and the patient's own cornea is preserved. For this reason, CAIRS is a less invasive option in suitable patients and can delay or eliminate the need for a corneal transplant.

Who Is CAIRS Suitable For?

CAIRS can be applied to patients with moderate to advanced keratoconus who cannot achieve adequate vision with glasses or contact lenses and who do not yet require a corneal transplant. It is a particularly good option for patients with thin corneas whose cornea is not thick enough for synthetic rings. Suitability is determined after a detailed examination and corneal topography.

What Is CAIRS Treatment and How Does It Differ from Conventional Rings?

CAIRS (Corneal Allogenic Intrastromal Ring Segments) is a method in which the ring segments used to support the cornea are prepared from donor corneal tissue instead of synthetic material. While conventional rings (INTACS, Keraring) use a plastic segment, CAIRS uses natural tissue, making it more compatible with the cornea and significantly reducing the risk of extrusion.

Is Permanent Vision Correction Possible for Keratoconus?

Yes. After stopping the progression with Cross-Linking, permanent vision correction can be achieved through specially designed contact lenses, phakic intraocular lenses (ICL/IPCL), or in advanced cases, corneal transplantation.

Is Laser Treatment Applicable in This Disease?

No. Conventional laser treatments (LASIK, PRK) are not used in keratoconus patients. However, corneal strengthening through a procedure called Cross-Linking is an effective option to stop the progression of the disease.

Is Keratoconus Only Genetic, or Can It Develop Later?

Genetic predisposition is a major factor, but frequent eye rubbing, allergic tendencies, and eye trauma can also trigger the development of keratoconus. Regular eye screenings at an early age are critical for early diagnosis.

Can Keratoconus Lead to Blindness?

If left untreated, advanced-stage keratoconus can lead to significant vision loss. However, with early diagnosis and proper treatment, the progression of the disease can be controlled. It is very important to consult an eye specialist without delay.

Could Constant Changes in My Glasses Prescription Be Caused by Keratoconus?

Yes. Frequent and rapid changes in prescription are very common in patients with keratoconus. If your astigmatism is increasing and you can’t see clearly even with glasses, the structure of your cornea should be examined.

Keratoconus is a progressive eye disease characterized by the gradual thinning of the cornea and its protrusion forward into a cone shape. Normally shaped like a smooth, regular dome, the cornea takes on a conical form in this condition, preventing light from focusing properly on the retina; this leads to myopia and irregular astigmatism, reducing visual quality. It usually begins in younger years and can progress over time. With early diagnosis and appropriate treatment, the progression of the disease can be slowed and even halted, and visual quality can be preserved. For this reason, individuals whose eyeglass prescription changes frequently should be evaluated with corneal topography.

Treatment Overview

It usually begins between the ages of 10–30 and may progress into the 40s.
Treatment is required if glasses or lenses do not sufficiently correct vision.
As it is a progressive condition, regular follow-up is essential.
Treatment is planned individually according to the stage of the disease and the structure of the cornea.
In the early stage, special contact lenses can improve visual acuity.
Cross-Linking (corneal collagen cross-linking) is applied to halt progression.
In moderate and advanced stages, surgical methods such as intrastromal corneal ring segments and CAIRS may be applied.
Corneal transplantation is preferred only as a last resort, in advanced cases.

How Is Keratoconus Treatment Performed?

The goal of keratoconus treatment is to strengthen the corneal tissue and stop the progression of the disease. The method to be applied is determined individually according to the thickness of the cornea, the stage of the disease, and the patient’s visual needs.

Anesthesia
Local anesthesia is applied with eye drops. No needles are used; it is a painless and comfortable procedure.

Intrastromal Ring Implantation
In moderate keratoconus, special crescent-shaped rings are placed inside the cornea to help it flatten. This method supports the corneal structure, reduces astigmatism, and improves visual quality.

CAIRS (Allogenic Tissue Ring Segments)
As a natural alternative to synthetic rings, the CAIRS method involves implanting ring segments prepared from donor corneal tissue into the cornea. Because it integrates with the tissue, it has a low risk of extrusion and high biocompatibility; it is a current option that can delay corneal transplantation, especially in patients with thin corneas.

Corneal Cross-Linking
In this method applied for progressive keratoconus, the corneal tissue is strengthened with riboflavin drops and UV light. By forming new bonds between the connective tissue fibers of the cornea, it reinforces the structure and largely slows or stops the progression of the disease.

Advanced-Stage Treatment: Corneal Transplantation
In patients whose cornea has thinned severely and become significantly distorted, a full-thickness or partial-thickness corneal transplant may be performed to restore vision. Thanks to current surgical options, transplantation is preferred only as a last resort, when other methods are insufficient.

Recovery Process
The recovery time varies depending on the method applied. After Cross-Linking, relief is achieved within a few days. After ring and CAIRS procedures, visual quality improves noticeably within a few weeks. The recovery process after a corneal transplant is longer and requires regular follow-up.

Keratoconus Treatment in Izmir

Keratoconus is a progressive disease involving the thinning of the corneal tissue—the transparent layer of the eye—and its protrusion and steepening forward. This shape distortion in the cornea causes myopia and irregular astigmatism, leading to reduced vision and a decline in visual quality. Although it can occur in both eyes, one eye is usually affected somewhat more than the other. At our clinic in Izmir, we treat keratoconus individually using current methods, from early diagnosis to advanced-stage surgery.

Who Is Affected by Keratoconus?

Although the exact cause of keratoconus is unknown, genetic predisposition and mechanical trauma such as frequent eye rubbing are among the important contributing factors. The disease usually begins around the age of 12–13 and may continue to progress into the 40s. The keratoconus patients we see in the clinic are generally individuals who change their glasses frequently and have a predisposition to allergic conjunctivitis. It is seen more frequently in people who live in dry, windy, and dusty environments and who rub their eyes often. Keratoconus may at times be accompanied by an eye-rubbing habit and irritation on the corneal surface; it should be noted that similar complaints can also arise from other corneal diseases such as corneal inflammation (keratitis). For this reason, an eye examination is essential for an accurate diagnosis.

What Are the Symptoms of Keratoconus?

One of the earliest signs of keratoconus is the frequent change of eyeglass prescriptions. Even with these changing prescriptions, it is not possible to achieve fully sharp vision. Because the shape change in the cornea resulting from its forward protrusion creates myopia and irregular astigmatism, it cannot be fully corrected with glasses either. The most common symptoms seen in patients are:

Frequent and rapid changes in eyeglass prescription
Inability to see clearly and sharply even with glasses
Light sensitivity and seeing halos around lights
Difficulty seeing at night and glare
Double vision or shadowing in the image
Frequent itching and a feeling of dryness in the eyes

How Is Keratoconus Diagnosed?

Following a detailed vision examination, we can easily make the diagnosis with a corneal topography test. This test maps the surface of the cornea, allowing us to evaluate the stage of the disease and its rate of progression; thus, the treatment plan is determined individually for each patient.

Keratoconus Treatment

There is no treatment that fully reverses keratoconus. All treatment options are aimed at stopping the progression of the disease and correcting the visual impairment. For this reason, early diagnosis and regular follow-up play a decisive role in the success of the treatment.

If we examine the treatment options for keratoconus step by step, in patients at a very early stage it is possible to improve visual acuity with glasses. The progression of the disease can be evaluated with corneal topography tests performed at 6-month intervals.

In more advanced stages, it may not be possible to improve visual acuity with glasses; in this case, special contact lenses (hybrid, scleral, or rigid gas permeable) can be used. If we determine that the disease is progressive, we apply Cross-Linking (corneal collagen cross-linking) treatment. If contact lenses and glasses do not provide benefit in improving visual acuity, we may make use of Intrastromal Corneal Ring (Corneal Ring) treatment. As a natural alternative to synthetic rings, we also prefer the CAIRS (Corneal Allogenic Intrastromal Ring Segments) method in suitable patients; this method offers a low complication risk, especially in patients with thin corneas. In advanced cases, the phakic intraocular lens (ICL/IPCL) option can also be considered for permanent vision correction. In very advanced keratoconus patients, a corneal transplant—which we call Corneal Transplantation (PKP, DALK)—may be performed.

The Cross-Linking treatment we apply in keratoconus patients to stop the progression of the disease. With this method, the progression of the disease can be halted at a rate of approximately 95%. After the procedure, patients may experience complaints such as burning and stinging for 3–4 days. Following this period, the patient can usually return to daily life without any problems.

In Summary;

In the early stage, Glasses or Contact Lenses
In more advanced stages, Corneal Ring and the natural tissue option CAIRS
To stop the progression of the disease, Cross-Linking treatment
In end-stage disease, Corneal Transplant may be applied.

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