Evidence map›Paper›PMID 41961335›Full record

ArticleInternational ophthalmology2026

From synthetic to biological rings: CAIRS for visual preservation after PMMA ICRS extrusion in keratoconus, a case report.

Adel Barbara, Ramez Barbara

Abstract readCase ReportsLetter
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In one paragraph

Article in International ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Adel BarbaraIVISION Refractive and Keratoconus Treatment Center, Haifa, Israel. adelbarbara@yahoo.com.
Ramez BarbaraOphthalmology Department, Integrated Surgical Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo 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.

conclusionPartial 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.

Indexed as

Corneal StromaKeratoconusPolymethyl MethacrylateProstheses and ImplantsProsthesis ImplantationVisual AcuityAdultCorneal TopographyHumansPolymethyl Methacrylate

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.