Safety Profile Of Corneal Allograft Intrastromal Ring Segment (Cairs) Implantation In A Large Cohort

Published 2026 - 44th Congress of the ESCRS

Reference: PP05.16 | Type: Free paper | DOI: 10.82333/8dk5-5g85

Authors: Dr Burcu Yakut* ¹ , Dr Fatma Feyza Nur Keskin Perk ² , Dr Dilan Çolak Arıcı ³ , Dr Uğur Tunç ⁴ , Dr Metin Suleymanzade ⁵ , Dr Sepideh Lotfi ⁵ , Dr Aylin Kılıç ⁶

¹Ophthalmology,Haseki Training and Research Hospita,Istanbul,Türkiye, ²Ophthalmology, Cam and Sakura City Hospital,Istanbul,Türkiye, ³Ophthalmology,Beyoglu Eye Training and Research Hospital,Istanbul,Türkiye, ⁴Ophthalmology, Medipol University,Istanbul,Türkiye, ⁵Ophthalmology, Biruni University,Istanbul,Türkiye, ⁶Ophthalmology,Swiss Vision Group,Istanbul,Türkiye

Purpose

To evaluate visual, refractive, and tomographic outcomes and complication profiles after Keranatural implantation.

Setting

Swiss Vision Clinic, İstanbul, Türkiye

Methods

A retrospective analysis was performed on 405 eyes that had undergone Keranatural implantation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), maximum keratometry (Kmax), mean keratometry (Kmean), and pachymetry were analyzed preoperatively and postoperatively. Paired t-test was used for comparison.

The mean follow-up was 7.9 months (range: 3-48 months). Perioperative and postoperative complications were recorded.

Results

CDVA improved from 0.29±0.19 to 0.79±0.26 (p<0.001) and UCVA from 0.17±0.16 to 0.47±0.27 (p<0.001). SE improved from −5.02±4.59 D to −1.30±3.30 D (p<0.001). Kmean decreased significantly from 50.17±4.97 D to 47.07±4.88 D (p=0.0007), whereas Kmax reduction (59.22±7.57 D to 58.11±6.94 D) was not significant (p=0.426). Pachymetry remained stable (436.1±44.7 µm vs 435.3±45.9 µm; p=0.606). Two transient CDVA decreases resolved after revision. One intraoperative flap separation and one stromal melting/exposure after subsequent CXL were observed. No persistent vision loss or rejection occurred. Dry eye was seen in ~60%, but none after preoperative LipiFlow (83 eyes). Yellow deposits were seen in 16% without inflammation or visual compromise.

Conclusions

CAIRS provides significant visual and refractive improvement. The complication rate was low and manageable. The absence of rejection supports the immunologic safety of electron beam sterilized corneal tissue. Preoperative ocular surface optimization may reduce postoperative dry eye symptoms. Overall, Keranatural appears to be a safe and effective surgical method.