I wrote this page for patients who come from other cities in Türkiye, such as Istanbul and Izmir, or from abroad. I carry out the examination and the surgery in one place; the address is in the appointment section at the end of the page. That is why it matters to plan the journey properly from the start.
What I describe below is my own practice: the timings, the check-up days and the limits are written as I apply them. I do not repeat here what CAIRS is, whom it is for and what its risks are; all of that is on the CAIRS surgery page. One reminder: CAIRS regularises the shape of the cornea with a ring segment prepared from donor corneal tissue; it does not halt the progression of keratoconus. The treatment that aims to halt it is corneal cross-linking (CXL).
The short timeline
- Before you come: you send me your topography and I make a preliminary assessment. If you wear contact lenses, you stop wearing them.
- The day you arrive: examination and measurements; if you are suitable, surgery on the same day.
- The next morning: the first check-up. After that you can travel home.
- Month 1: check-up; it can be with your own eye doctor in your home city.
- Month 3: you send me your topography.
Before you come
Send your topography and I will make a preliminary assessment
If you have a corneal topography, send it to me before you set off: send your topography via Instagram. The username is @opdrserkangureser; it is a verified (blue tick) account, so do not confuse it with accounts that have similar names. Tell me the date of the printout as well.
I will look at it and tell you whether CAIRS is worth discussing in your case. This is a preliminary assessment; it does not replace the examination. I make the final decision at the examination, with new measurements taken here. In other words, my saying "come" after the preliminary assessment does not mean that the surgery is confirmed.
If you have no topography at all, I cannot tell you anything from a distance; in that case the assessment is made directly at the examination.
If you wear contact lenses
In my practice: I ask you to stop wearing soft lenses 5 days before the measurements, and rigid or toric lenses 2 weeks before. Once you have stopped, do not wear lenses again until the surgery.
My reasoning is this: a lens changes the shape of the cornea and can make its surface layer (the epithelium) more sensitive. I plan the surgery from the measurements; a measurement taken under the influence of a lens affects the plan too. If you come without having stopped your lenses, I cannot rely on the measurements and it may not be possible to plan surgery for the same day. For a patient travelling from far away, that means a second journey.
A short note on suitability
I generally look for at least 350 µm at the thinnest point of the cornea. If there is no scar and the thinnest point does not coincide with the area where I will create the channel, I also operate down to 300 µm. If the cornea has a significant or central scar, I do not perform CAIRS. These are my own limits; the detail and the reasoning are on the CAIRS surgery page.
What this means in practice: Before you buy a ticket, get two things done: send your topography, and write in your calendar the day on which you will stop wearing your lenses. Choose the appointment day according to the lens-free period.
The day you arrive: examination and surgery
First I examine you and repeat the measurements. If I find you suitable, the surgery can be done on the same day; because the donor tissue I use is kept ready with us, no separate waiting time is needed.
In my practice: I perform the surgery under eye-drop anaesthesia, and it takes about 10 minutes. I do not place sutures. I put a bandage contact lens on the eye, which stays for 1 day, and I start the steroid eye drops that you will use for 1 month.
If you have keratoconus in both eyes
If both eyes are suitable, I see no objection to operating on both eyes in the same session; in that case two separate journeys are not needed. If one of the eyes is not suitable or its measurements are different, I make the plan separately for each eye.
The next day: check-up and the journey home
I do the first check-up on the morning after surgery. For that reason, plan to stay one night even though the procedure itself takes a single day.
Flying: I see no objection to your taking a flight the next day.
Driving: the interval in my practice is 3 days. The natural consequence is this: if you came in your own car, you should not be the one at the wheel on the way back. If you are coming by car, have someone with you who can drive.
If you have a different travel plan (a long road journey, a return with connections and so on), we discuss it before you come.
What this means in practice: Book your return ticket not for the day of surgery but for the next day; leave a departure time that lets you attend the morning check-up.
After you return home
Check-ups: which are with me, which in your home city
The schedule in my practice: the check-up on the next morning is with me. You can have the month 1 check-up with your own eye doctor in your home city. At month 3 I ask you to have a topography taken and send it to me; that is the map with which I look at the new shape of the cornea.
Before you leave, we discuss what you need to ask of your own doctor and how you will get the month 3 topography to me. We also set the interval for later check-ups at that point. Because CAIRS does not halt progression, topography monitoring continues after surgery as well.
Returning to daily life
The timings in my practice:
- Driving: after 3 days.
- Returning to work: 3–7 days.
- Water: no water should touch the eye for the first 5 days; after day 5 it may.
- Eye make-up, sport, swimming: after 2 weeks.
- Steroid eye drops: 1 month.
Do not rub your eye. This is not a rule for the first days only; it applies for as long as you live with keratoconus.
How to reach me if there is a problem
This is the most reasonable worry of a patient who travels from far away: "What if something happens after I get back?" I give the patients I operate on a number on which they can reach me directly; you can always ask whenever something is on your mind.
If you have increasing pain, increasing redness, discharge or a sudden drop in vision, do not wait for your check-up day; call me, and see an eye doctor where you are.
What this means in practice: Before you set off, decide which eye doctor in your home city will do the month 1 check-up and where you will have the month 3 topography taken. Do not leave yourself having to look for them once you are back.
If CAIRS turns out not to be suitable for you
The preliminary assessment reduces this possibility but does not remove it: a scar that I see at the examination, or a value in the new measurements, can change the decision. I want you to know this before you set off.
Turning out not to be suitable does not mean that you came for nothing. At the same examination we discuss which step you are on: monitoring, corneal cross-linking, specialised contact lenses or a corneal transplant. I have explained the steps in this article: CXL or CAIRS: read which step you are on. If you are coming for your child or for a teenage relative, read this first: Your child has keratoconus: is waiting always safe?
Checklist before you set off
- I have sent my topography via Instagram and received the preliminary assessment.
- I stopped wearing soft lenses 5 days before the measurements, or rigid or toric lenses 2 weeks before.
- I have packed the earlier topographies I have.
- I have planned to stay one night; I travel home after the check-up the next morning.
- If I am coming by car, I have someone with me who will drive on the way back.
- I have arranged 3–7 days off work.
- I know which eye doctor in my home city will do the month 1 check-up and where I will have the month 3 topography taken.
Frequently asked questions
How many days do I need to stay for CAIRS?
A single day is enough for the surgery: in patients I find suitable, the examination and the surgery can be done on the same day. Because I do the first check-up the next morning, plan to stay one night. You can travel home after the check-up.
Can the examination and the surgery be done on the same day?
Yes, they can; because the donor tissue I use is kept ready, no separate wait is needed. The condition is this: the examination and the measurements taken that day must show that you are suitable for CAIRS. If you have not stopped wearing your lenses for as long beforehand as I recommend, I cannot rely on the measurements and the surgery may have to move to another day.
When can I fly after the surgery, and when can I drive?
I see no objection to your taking a flight the next day. For driving, the interval in my practice is 3 days; so if you came in your own car, someone else should drive on the way back. If you have a different travel plan, we discuss it before you come.
Can I have my check-ups with an eye doctor in my own city?
I do the first check-up, on the next morning, myself. You can have the month 1 check-up with your own eye doctor in your home city; at month 3 I ask you to send me your topography. Before you leave, we discuss what you need to ask of your doctor and the later check-ups.
How long before I come should I stop wearing contact lenses?
In my practice: soft lenses are stopped 5 days before the measurements, rigid or toric lenses 2 weeks before, and they are not worn again until the surgery. A lens changes the shape of the cornea and can make its surface layer more sensitive; because I make the plan from the measurements, the measurements need to be free of the effect of the lens.
How can I send my topography before I come?
You can send it by message to the @opdrserkangureser account on Instagram; it is a verified (blue tick) account. I will look at it and make a preliminary assessment. The preliminary assessment does not replace the examination; I make the final decision with the examination and new measurements.
I have keratoconus in both eyes; do I need to come twice?
If both eyes are suitable, I see no objection to operating on both eyes in the same session; in that case a single journey is enough. If one of the eyes is not suitable or its measurements are different, I make the plan separately for each eye.
Whom do I contact if there is a problem after I get back?
I give the patients I operate on a number on which they can reach me directly; you can always ask. If you have increasing pain, increasing redness, discharge or a sudden drop in vision, do not wait for your check-up day: call me, and see an eye doctor where you are.
Assessment appointment
Let us assess together, with your topography and an examination, whether you are suitable for CAIRS.
You can send your topography via Instagram before you come; I will give a preliminary opinion, which is not a diagnosis.