PURPOSE: To report the combined approach of corneal allogeneic intrastromal ring segment (CAIRS) transplantation and cataract surgery in a cataract patient with corneal ectasia.

CASE REPORT: A 75-year-old male presented with age-related corticonuclear cataract, high myopia, and corneal ectasia on his right eye. After detailed discussion of treatment options, the patient wished to undergo a combined approach of CAIRS procedure and cataract surgery on his right eye. A femtosecond-laser (Wavelight FS200, Alcon, USA) was used to create a corneal pocket at mid-stromal depth and incision at 190°. Then, cataract surgery was performed with a 2.5-mm corneal incision, manual capsulorhexis, and phacoemulsification. A 3-piece intraocular lens (IOL) with a dioptric power of 0 diopter (D) (target refraction: -3.0 D) was implanted into the capsular bag. After cataract surgery, an 8-mm CAIRS tissue with 160° arc and 500 μm thickness was inserted (KeraNatural, VisionGift, USA) into the stromal pocket. Follow-up examination at 3-months postoperatively demonstrated improved uncorrected (UDVA) and corrected distance visual acuity (CDVA), topographic parameters, as well as high satisfaction rate.

CONCLUSIONS: Our case report shows that an immediate sequential CAIRS transplantation and cataract surgery may be a viable option in managing cataract patients with corneal ectasia.