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Instruments

by David Gunn

There are lots of instrument options. If you use a femtosecond laser to make the channels, you need relatively little dedicated channel equipment: at a minimum, a curved Y pusher is very helpful for advancing tissue along a long tunnel.

If you are making the channels manually, you will need to buy the appropriate dissectors for your planned channel geometry. Add separators, pullers or forceps to suit your insertion and handling technique.

Tools for making the donor implant are a separate choice: manual trephination and customisation need their own preparation instruments.

Cronin–Gunn instruments

Developed with Dr Brendan Cronin and Dr David Gunn. The titanium set follows a 6 mm channel curve, with clockwise and counter-clockwise configurations.

Closer view of the curved separator, pusher and puller tips in the Cronin–Gunn set.

Cronin–Gunn CAIRS set
Show full instrument photo Blue titanium Cronin–Gunn CAIRS instruments with curved separator, pusher and puller tips, photographed by SRB Devices.

SRB Devices

Separator, pusher and puller for opening the channel, advancing the segment and drawing it into position.

Choose the directional instruments for the insertion path you have planned.

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Dr Gunn and Dr Cronin have no financial interest in these instruments.

Soosan Jacob’s trephines and customiser

The trephine creates the donor ring. The rounded customiser helps transfer a personalised shape and arc-length plan onto the tissue.

Close view of the two concentric cutting edges of the Jacob CAIRS trephine, from Madhu Instruments.

Jacob CAIRS trephines
Show full instrument photo Jacob CAIRS trephine kit with vacuum syringe and cutting components, photographed by Madhu Instruments.

Madhu Instruments

Two concentric blades cut a donor stromal ring for manual preparation. The blade pair determines the annular width before the strip is orientated and customised.

The 2025 catalogue lists inner / outer diameter pairs of 5.50 / 9.50, 6.50 / 8.00, 7.75 / 8.75 and 8.00 / 9.50 mm. Check the current catalogue for the required size.

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Jacob CAIRS customiser in use, showing its domed surface, optical-zone circles and radial markings, photographed by Soosan Jacob.

Jacob CAIRS customiser

Epsilon USA · EB-39

The round, domed template — the “ball” — is used to mark arc length and taper transition points before manually shaping the segment.

Align the tissue to the planned optical zone and meridians, mark the intended shape, then trim on a suitable cutting surface using the trained technique.

Photograph: Soosan Jacob.

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Awwad CAIRS instruments · Epsilon

Epsilon’s set brings together marking, dissection, preparation and insertion tools, including the Awwad micro forceps and graduated dehydration mould.

The complete Epsilon Awwad CAIRS set, with marking, dissection, preparation and insertion instruments labelled by the supplier.
Full CAIRS set photograph: Epsilon USA. Open the full-size image →
Close view of the left and right Awwad CAIRS micro forceps working tips.

Awwad CAIRS micro forceps
Show full instrument photo Left and right Awwad CAIRS micro forceps from Epsilon’s set photograph.

Epsilon USA · EA-50L SS / EA-50R SS

Left and right 23G stainless-steel micrograspers for controlling and adjusting the allogenic segment within the tunnel.

Dr Awwad’s short video demonstrates these dedicated CAIRS forceps.

View instruments Watch Shady Awwad
Closer view of the three-blade CLEAR marker and its central reference on the cornea.

Awwad CLEAR marker
Show full instrument photo Awwad three-blade CLEAR marker centred on a cornea, shown in Ziemer’s published surgical technique.

Epsilon USA · ET-32

The three-blade marker for CLEAR transfers centration and axis references onto the cornea before femtosecond laser docking.

Centre the marking reference on the intended light reflex and maintain that reference through docking. The photo shows the marker in use.

View instruments Watch the marking workflow
Circular Awwad graduated dehydration mould from Epsilon’s CAIRS set photograph.

Awwad dehydration mould

Epsilon USA · ET-36

A graduated circular mould that supports the segment’s arc shape during dehydration and provides degree references for preparation.

Choose the geometry and hydration workflow that match the intended implant and channel.

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Also listed in the set: a Y probe, CAIRS dissector, left/right Jacob hooks and Y pushers, Boxer dissector probes, scissors and tissue forceps. See the complete Epsilon set →

Aylin Kılıç · AK instruments

AK instruments were developed by Dr Aylin Kılıç for the KeraNatural CAIRS workflow. The instrument guide lists Optimal Sağlık, Istanbul, as the distributor.

Close view of the AK Marker’s circular working face and radial sectors.

AK Marker
Show full instrument photo Aylin Kılıç’s AK Marker with a circular ring divided into radial sectors, from her own instrument photograph.

Aylin Kılıç · Optimal Sağlık

A marker for transferring the planned start, end and arc length onto the cornea, using 30-degree sectors to reproduce the topographic orientation.

Photograph from Dr Kılıç’s own introduction of the instrument. Ask the distributor for the current specifications.

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Close view of the curved blue titanium AK forceps tips in Aylin Kılıç’s published CAIRS set photo.

AK forceps
Show full instrument photo Blue titanium AK forceps from Aylin Kılıç’s own CAIRS instrument set photograph.

Aylin Kılıç · Optimal Sağlık

Titanium forceps for tissue handling and implantation in the KeraNatural workflow. The curved working ends help control the tissue during insertion.

Photograph from Dr Kılıç’s own introduction of the CAIRS set.

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Close view of the opposing curved tips of the right and left AK tunnel separators.

AK tunnel separators
Show full instrument photo Right and left stainless-steel AK tunnel separators from Aylin Kılıç’s own instrument set photograph.

Aylin Kılıç · Optimal Sağlık

Right and left stainless-steel separators for accessing and opening the tunnel before insertion. The pair provides opposing directions of curvature.

Listed individually or as a paired set in the KeraNatural instrument guide. Photograph from Dr Kılıç.

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Rumex / LWVI CAIRS treatment set

Developed with Lions World Vision Institute, this set supports manual channel creation and segment insertion. It brings together marking, fixation, tunnel dissection and implantation instruments for a workflow without a femtosecond channel laser.

Supplier photographs of all 17 entries in the set. Open a photograph for a closer view; dissector widths and left/right variants are available from Rumex.

  • Rumex Corneal marker, catalogue 3-0231.

    Corneal marker

    3-0231

  • Rumex Mendez degree gauge, catalogue 2-0331T.

    Mendez degree gauge

    2-0331T

  • Rumex Tunnel zone marker, catalogue 3-143T.

    Tunnel zone marker

    3-143T

  • Rumex Diamond knife, catalogue 6-00 / 6-020.

    Diamond knife

    6-00 / 6-020

  • Rumex ICRS elevator, catalogue 10-035.

    ICRS elevator

    10-035

  • Rumex 4.5 mm CAIRS dissector, catalogue 16-175.

    4.5 mm CAIRS dissector

    16-175

  • Rumex 5.5 mm CAIRS dissector, catalogue 16-176.

    5.5 mm CAIRS dissector

    16-176

  • Rumex Vacuum stabilisation guide, catalogue 16-315T.

    Vacuum stabilisation guide

    16-315T

  • Rumex Suarez spreader, catalogue 13-146.

    Suarez spreader

    13-146

  • Rumex Bicalto guide, catalogue 13-147.

    Bicalto guide

    13-147

  • Rumex Castroviejo fixation forceps, catalogue 4-0822T.

    Castroviejo fixation forceps

    4-0822T

  • Rumex McPherson tying forceps, catalogue 4-178S.

    McPherson tying forceps

    4-178S

  • Rumex Reversed Sinskey hook, catalogue 5-0322.

    Reversed Sinskey hook

    5-0322

  • Rumex Right Y pusher, catalogue 5-080.

    Right Y pusher

    5-080

  • Rumex Left Y pusher, catalogue 5-081.

    Left Y pusher

    5-081

  • Rumex Thornton fixation ring, catalogue 16-036S.

    Thornton fixation ring

    16-036S

  • Rumex Sterilisation tray, catalogue 18-304.

    Sterilisation tray

    18-304

View the complete Rumex set ↗ Download the supplier leaflet ↗

Read about the manual channel option →

Instrument photographs: SRB Devices, Madhu Instruments, Epsilon USA, Rumex, Dr Soosan Jacob and Dr Aylin Kılıç. CLEAR marker in use: Ziemer technique supplement.

Complete the theatre set

Alongside the dedicated CAIRS tools, prepare the routine instruments and consumables for your chosen method: corneal marking and angle measurement, fine tissue forceps, scissors for arc-length trimming, and the tissue preparation surface or artificial anterior chamber where required. Manual channel creation needs its own trained dissection workflow and instruments.

Practise with the exact instruments you intend to use before your first patient. Familiarity with their curvature, direction and tissue grip makes it easier to recognise what is happening during insertion.

Teaching and further reading

Instrument roles follow the CAIRS teaching library. Product details are drawn from the supplier and designer sources linked below; confirm current sizes and ordering details with the supplier.