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From synthetic to biological rings: CAIRS for visual preservation after PMMA ICRS extrusion in keratoconus, a case
1IVISION Refractive and Keratoconus Treatment Center, Haifa, Israel. adelbarbara@yahoo.com.
Purpose:
To report the outcome of partial replacement of an extruded PMMA intracorneal ring segment (ICRS) with corneal allogenic intrastromal ring segment (CAIRS) in advanced keratoconus.
Case Presentation:
A patient with advanced keratoconus previously treated with a pair of Ferrara ring segments, achieved stable visual improvement for over 20 years. In 2024, extrusion of one segment occurred. The extruded PMMA segment was removed and replaced with a full-thickness CAIRS, while the second segment was left in situ. Despite technical challenges in adapting the CAIRS to the pre-existing tunnel, implantation was successful and visual acuity was preserved.
Conclusion:
Partial exchange of an extruded ICRS with CAIRS is feasible and may maintain prior visual and biomechanical gains, offering an alternative to complete segment removal in selected cases.
