{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:59:14Z","timestamp":1790017154572,"version":"4.0.1"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Purpose To assess and describe the outcomes of corneal allograft intrastromal ring segment (CAIRS) implantation in eyes with keratoconus.<\/jats:p><jats:p>\n          Methods In this retrospective analysis, we examined the early postoperative results of CAIRS (KeraNatural) implantation after cutting a corneal tunnel with a femtosecond laser device (Ziemer Z6) in patients with keratoconus. Outcome measures included best-corrected distance visual acuity (BCDVA), spherical equivalent (SE), maximal keratometry (Kmax), refractive astigmatism (RA), higher-order aberrations (HOAs), and root mean square total aberrations (total RMS), evaluated both before and a variable time after surgery, ranging from at least 30 days to 338 days, with a mean follow-up time of 141.1\u2009\u00b1\u200979.9 days postoperatively.<\/jats:p><jats:p>\n          Results A total of 17 eyes with keratoconus of 16 patients (mean age of 36.2\u2009\u00b1\u200917.3 years) were treated. In one eye, previous corneal UVA cross-linking (CXL) was reported in the medical history, and 9 eyes underwent adjunctive CXL at least 1 month postoperatively due to previously documented progressive disease. BCDVA (mean\u2009\u00b1\u2009SD) improved from preoperative values of 0.43\u2009\u00b1\u20090.16\u2009logMAR to 0.19\u2009\u00b1\u20090.14\u2009logMAR postoperatively (p\u2009&lt;\u20090.001). Furthermore, the results show a significant decrease in spherical and astigmatic refraction, with the mean SE decreasing from \u2212\u20092.9\u2009\u00b1\u20094.7\u2009D to \u2212\u20090.7\u2009\u00b1\u20093.6\u2009D (p\u2009=\u20090.004). Mean RA slightly changed from \u2212\u20093.42\u2009\u00b1\u20092.18\u2009D to \u2212\u20092.51\u2009\u00b1\u20092.31\u2009D (p\u2009=\u20090.13). Additionally, mean Kmax significantly decreased from 57.3\u2009\u00b1\u20095.5\u2009D to 51.4\u2009\u00b1\u20095.7\u2009D (p\u2009&lt;\u20090.001). In the comparison of pre- to postoperative HOA and total RMS values at 4, 5, and 6\u2009mm, a slight tendency for improvement was found; however, these changes were not statistically\n          significant (p\u2009&gt;\u20090.05, each).<\/jats:p><jats:p>\n          Conclusion CAIRS implantation reduced corneal ectasia and improved BCDVA in patients with keratoconus. This highlights its potential as an effective visual rehabilitation strategy, particularly for patients who are intolerant to wearing contact lenses.<\/jats:p>","DOI":"10.1055\/a-2526-2105","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T23:57:56Z","timestamp":1740700676000},"page":"328-331","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes after Implantation of KeraNatural, a Sterile Corneal Allograft Intrastromal Ring Segment (CAIRS), in Eyes with Keratoconus"],"prefix":"10.1055","volume":"242","author":[{"given":"Evelyn-Elisa","family":"Benz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pallas Kliniken AG, Olten\/Zurich\/Bern, Olten, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6907-1112","authenticated-orcid":false,"given":"Christoph","family":"Tappeiner","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pallas Kliniken AG, Olten\/Zurich\/Bern, Olten, Switzerland"},{"name":"Department of Ophthalmology, University Hospital Essen, University Duisburg-Essen, Essen, Germany"},{"name":"Medical Faculty, University of Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2119-1710","authenticated-orcid":false,"given":"David","family":"Goldblum","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pallas Kliniken AG, Olten\/Zurich\/Bern, Olten, Switzerland"},{"name":"Medical Faculty, University of Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Kyroudis","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pallas Kliniken AG, Olten\/Zurich\/Bern, Olten, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2019","DOI":"10.2147\/OPTH.S50119","article-title":"Keratoconus: current perspectives","volume":"7","author":"J Vazirani","year":"2013","journal-title":"Clin Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.4103\/sjopt.sjopt_204_21","article-title":"Keratoconus epidemiology: A review","volume":"36","author":"J AP Gomes","year":"2022","journal-title":"Saudi J Ophthalmol"},{"key":"ref3","volume-title":"Keratoconus","author":"G Asimellis","year":"2024"},{"key":"ref4","first-page":"209","volume-title":"Intracorneal Ring Segments: Complications","author":"A K\u0131l\u0131\u00e7","year":"2017"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"296","DOI":"10.3928\/1081597X-20180223-01","article-title":"Corneal Allogenic Intrastromal Ring Segments (CAIRS) Combined With Corneal Cross-linking for Keratoconus","volume":"34","author":"S Jacob","year":"2018","journal-title":"J Refract Surg"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1177\/11206721221142995","article-title":"Allograft corneal ring segment for keratoconus management: Istanbul nomogram clinical results","author":"S Haciagaoglu","year":"2022","journal-title":"Eur J Ophthalmol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4274037","DOI":"10.1155\/2020\/4274037","article-title":"Intracorneal Stromal Ring Can Affect the Biomechanics of Ectatic Cornea","volume":"2020","author":"S Bamdad","year":"2020","journal-title":"J Ophthalmol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"767","DOI":"10.3928\/1081597X-20231011-01","article-title":"Corneal Allogenic Intrastromal Ring Segments (CAIRS) for Corneal Ectasia: A Comprehensive Segmental Tomography Evaluation","volume":"39","author":"Y Bteich","year":"2023","journal-title":"J Refract Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"3723","DOI":"10.4103\/IJO.IJO_1988_23","article-title":"Customized corneal allogenic intrastromal ring segments (CAIRS) for keratoconus with decentered asymmetric cone","volume":"71","author":"S Jacob","year":"2023","journal-title":"Indian J Ophthalmol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1055\/a-2252-3455","article-title":"Keratoconus Management by Insertion of an Allograft Corneal Ring Segment (KeraNatural)","volume":"241","author":"D Kyroudis","year":"2024","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"220","DOI":"10.3390\/jcm12010220","article-title":"Incidence of Complications Related to Corneal Graft in a Group of 758 Patients","volume":"12","author":"D Szkodny","year":"2022","journal-title":"J Clin Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"3807","DOI":"10.1038\/s41433-023-02618-5","article-title":"Efficacy and safety of intracorneal allogenic ring segment implantation in keratoconus: 1-year results","volume":"37","author":"S A Nacaroglu","year":"2023","journal-title":"Eye (Lond)"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"2361","DOI":"10.1007\/s40123-023-00765-2","article-title":"Allogenic Lenticular Implantation for Correction of Refractive Error and Ectasia: Narrative Review","volume":"12","author":"M Moshirfar","year":"2023","journal-title":"Ophthalmol Ther"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e392","DOI":"10.3928\/1081597X-20240501-01","article-title":"Effect of Corneal Allogenic Intrastromal Ring Segment (CAIRS) Implantation Surgery in Patients With Keratoconus According to Prior Corneal Cross-linking Status","volume":"40","author":"B Yucekul","year":"2024","journal-title":"J Refract Surg"}],"container-title":["Klinische Monatsbl\u00e4tter f\u00fcr Augenheilkunde"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2526-2105.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T22:41:20Z","timestamp":1744843280000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2526-2105"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,27]]},"references-count":14,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,4,16]]},"published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2526-2105","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0023-2165","1439-3999"],"issn-type":[{"value":"0023-2165","type":"print"},{"value":"1439-3999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,27]]}}}