A tissue-preserving keratoconus treatment in Sydney

CAIRS keratoplasty surgery is designed to reshape and support the cornea using donor tissue segments rather than a full transplant in suitable cases

A tissue-preserving keratoconus treatment in Sydney

CAIRS Keratoplasty Surgery is designed to reshape and support the cornea using donor tissue segments rather than a full transplant in suitable cases

With CAIRS keratoplasty surgery, patients may experience a more regular corneal shape and clearer vision

Quickly explore how CAIRS keratoplasty surgery works, who it may suit, and what to expect before, during, and after treatment

What is CAIRS keratoplasty surgery?

Corneal Allogenic Intrastromal Ring Segment (CAIRS) surgery is an innovative and tissue-preserving treatment designed to strengthen and reshape a weakened cornea using biologically compatible donor tissue. Unlike traditional corneal transplant surgery, CAIRS is a minimally invasive procedure that can restore vision and stability while maintaining the patient’s own corneal integrity. CAIRS represents the next generation of keratoplasty – combining surgical precision with a natural, regenerative approach.

CAIRS is primarily used to manage keratoconus and other forms of corneal ectasia — conditions where the cornea becomes progressively thinner and irregularly shaped, leading to blurred or distorted vision. It may also be beneficial for:

  • Post-LASIK ectasia (corneal weakening after laser surgery)
  • Pellucid marginal degeneration
  • Selected cases of corneal thinning or irregular astigmatism not responsive to other therapies
  • CAIRS can delay or even prevent the need for a full corneal transplant by reinforcing the cornea’s shape and strength earlier in the disease process.

You may be a suitable candidate for CAIRS if:

  • You have keratoconus or corneal ectasia with measurable thinning or irregularity
  • Your vision cannot be adequately corrected with glasses or contact lenses
  • The cornea still retains sufficient clarity for a ring segment to be implanted
  • You prefer a biological, minimally invasive option over synthetic implants or full-thickness transplantation.

A thorough consultation with our principal ophthalmologist, Dr John Males, including corneal topography, pachymetry, and a detailed ocular health assessment, will determine your suitability and expected outcome for this procedure or other treatments that may suit your personal circumstances.

CAIRS is performed under local anaesthetic and typically takes less than an hour. The procedure involves:

  • Creating a precise circular channel within the mid-layer of the cornea using a femtosecond laser
  • Inserting fine ring segments made from human donor corneal tissue (rather than synthetic material)
  • These allogenic segments gently reshape and stabilise the cornea, improving its curvature and optical quality.

Because the implants are biological, they integrate naturally with your own tissue, minimising inflammation and reducing the risk of complications associated with synthetic rings.

Most patients return home the same day, with recovery typically smoother and faster than traditional keratoplasty.

  • Minimally invasive – no full-thickness corneal graft required
  • Biocompatible – uses donor corneal tissue instead of plastic rings
  • Lower risk of rejection or extrusion
  • Faster recovery and less discomfort
  • Preserves corneal biomechanics and transparency
  • Can be combined with other treatments such as corneal collagen cross-linking for added strength and long-term stability.

What are the risks of CAIRS keratoplasty surgery?

While CAIRS is considered safe and effective, potential risks include:

  • Infection or inflammation
  • Over or under-correction of corneal shape
  • Segment displacement (rare)
  • Visual fluctuations during healing
  • The need for further enhancement or additional treatment if keratoconus progresses
  • We will discuss these risks in detail, ensuring you fully understand what to expect before deciding on surgery.

We know that your vision is precious. That’s why we offer a carefully curated, boutique experience designed around your comfort and confidence. In our personal and supportive environment, you’ll receive one-on-one care from your initial consultation through to recovery.

Our principal surgeon, Dr John Males, is a leader in laser vision correction, cataract and corneal surgery. We only use the latest in cutting-edge technology that will not only deliver results that are clinically sound, but genuinely life-enhancing. He is highly experienced in the diagnosis and treatment of Keratoconus.

Dr Males will be able to recommend the best treatment options for your individual presentation. This could be CAIRS keratoplasty surgery, or a range of other solutions from Corneal Rings, Gas Permeable Contact Lenses, Corneal Transplant, to Collagen Cross Linking Surgery (UVX).

Is CAIRS the same as Intacs or synthetic corneal rings?
No. Unlike Intacs or Kerarings, CAIRS uses natural donor corneal tissue, which integrates with the eye and offers a more biologically harmonious solution.

Can CAIRS be performed alongside corneal cross-linking?
Yes. In many cases, CAIRS is performed together with corneal collagen cross-linking (UVX) to both reshape and strengthen the cornea, maximising long-term results.

Will I still need glasses or contact lenses?
Some patients may still require corrective lenses for fine-tuning, but dependence is often reduced, and overall visual quality improved.

Is the donor tissue safe?
Absolutely. Donor tissue used for CAIRS is ethically sourced, thoroughly screened, and prepared according to stringent medical standards to ensure safety and biocompatibility.

Clear guidance for your eye care journey

Eye treatment options can vary from person to person. We help you understand what is happening and what care may be right for you

Step 1: REACH OUT

The first step is to book an assessment so your symptoms, concerns, or vision goals can be discussed with the clinic. Give our friendly team a call or use our easy online calendar to book a free assessment.

Step 2: WE’LL MEET

At your visit, our refractive surgeons will examine your eyes, explain the findings, and talk through the treatment options that may be appropriate for your condition and needs.

Step 3: ENJOY COMFORT

After treatment, the aim is to help you see more clearly, feel more comfortable, and manage your eye health with greater confidence. Depending on your condition and treatment plan, this may make daily life feel easier and more manageable.

Find comfort and clarity for your eyes

Take our free online assessment to discover the next step toward healthier, more comfortable vision

Hi, I’m Dr John Males

I’m the owner and principal surgeon at Envision Eye Centre, specialising in laser vision correction, cataract, and corneal surgery. With over 15 years’ experience, I’ve been involved in introducing advanced procedures such as SMILE® and laser-assisted cataract surgery in Australia. I’ve held leadership roles at St Vincent’s Hospital and Sydney Eye Hospital, and I continue to contribute to teaching and research through the University of Sydney. My focus is always on delivering safe, precise, and personalised care, using the latest technology to help patients achieve the best possible visual outcomes.

Dr John Males

M.B B. Sc. (Med)(Hons) MMed (Clin Epi) FRANZCO