Background: Corneal allogeneic intrastromal ring segments (CAIRS) are a novel minimally invasive treatment option for keratoconus. Compared to synthetic intracorneal ring segments (ICRS), they offer greater biocompatibility and customizability thanks to the use of allogeneic tissue. The aim is to regularize the curvature of the cornea and improve visual acuity with as few complications as possible.
Objective: The aim of this review is to summarize and classify the current status of the efficacy, safety, patient selection, graft procurement and nomogram development in CAIRS.
Material and methods: A narrative literature review of relevant original studies, meta-analyses and review articles on CAIRS was conducted, supplemented by current clinical and technical developments as well as published nomograms (e.g., Jacob, Istanbul, Awwad, Brisbane).
Results: The literature shows consistent improvements in uncorrected and corrected distance visual acuity, Kmax and spherical equivalent. The CAIRS is associated with a low complication rate. Particularly positive results were achieved with individually customized segment geometry.
Conclusion: The CAIRS offers a high degree of customization and safety while maintaining good visual efficacy. Targeted patient selection is crucial for a good outcome. In the future, artificial intelligence (AI)-based nomograms could help to further optimize planning and improve the predictability of results.
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