Keratoconus Treatment in Brisbane.

Keratoconus is a condition where the normally round cornea progressively thins and bulges into a cone shape, causing distorted vision and increasing astigmatism. If you or a loved one has recently been diagnosed, you might be wondering: what are the most effective treatment options? And when is the right time to act?

In this post, we’ll walk through the modern treatments available for keratoconus—especially those offered by Dr David Gunn in Brisbane—and help you understand what options may be suitable depending on your stage of disease, age, and visual goals. To explore treatment options and book an appointment, visit our dedicated keratoconus page.

Early Detection Matters

Keratoconus most commonly begins during the teenage years and can progress into the 30s or beyond. The earlier it is detected, the more treatment options are available to preserve your vision. That’s why early diagnosis through corneal topography and progression monitoring is so important. At Dr Gunn’s Brisbane clinic, patients with suspected or confirmed keratoconus undergo high-resolution imaging with Pentacam or similar technology to map the exact curvature and thickness of the cornea.

Treatment Pathways: Cross-Linking, Lenses, and Surgery

There is no one-size-fits-all approach to treating keratoconus. The best treatment depends on how advanced the disease is, how fast it’s progressing, and how well the patient is seeing with glasses or contacts. Here are the most common modern treatments offered:

Corneal Cross-Linking (CXL)

This is the only proven method to halt or slow the progression of keratoconus. It works by applying vitamin B2 (riboflavin) drops to the cornea, then activating them with ultraviolet (UV) light to strengthen the collagen fibres in the corneal tissue.

Cross-linking is:

• Minimally invasive

• Performed under local anaesthetic as a day procedure

• Most effective in early-to-moderate keratoconus before scarring develops

Most patients in their teens or twenties are advised to undergo cross-linking if there are signs of progression, even if they still see well with glasses or contact lenses. If performed early enough, CXL can delay or prevent the need for corneal surgery later in life.

Custom Contact Lenses

Rigid gas permeable (RGP), hybrid, and scleral lenses are highly effective at restoring vision in keratoconus. These specialty lenses create a smooth optical surface over the irregular cornea, allowing for sharp focus even in advanced cases.

While contact lenses do not stop progression, they often delay the need for surgical intervention—especially when paired with cross-linking.. We work closely with experienced optometrists who specialise in fitting these lenses for keratoconus patients across Queensland.

CAIRS: A Breakthrough in Surgical Treatment

For patients who can no longer tolerate contact lenses or are experiencing irregular astigmatism that cannot be corrected with glasses, surgical options are available—and CAIRS (Corneal Allogenic Intrastromal Ring Segments) is leading a new era in treatment.

CAIRS is a minimally invasive corneal transplant. It involves placing ring segments made from human donor corneal tissue into the mid-layers of the patient’s own cornea. This helps reshape the cornea, reduce steepness and irregularity, and improve the ability to wear contact lenses—or in some cases, glasses—for better vision.

Dr David Gunn was the first surgeon in Australia to perform the CAIRS procedure, and continues to pioneer its use in the Asia-Pacific region. Patients from across Australia and the Pacific travel to Brisbane to undergo this advanced treatment with Dr Gunn.

Compared to synthetic intracorneal ring segments (ICRS), CAIRS offers several advantages:

• Biocompatibility – made from donor tissue, not synthetic material

• Better centration and stability – less likelihood of ring migration

• Lower complication rates – reduced risk of extrusion or inflammation

• Improved visual outcomes – smoother corneal shape with fewer artefacts

CAIRS is suitable for patients with moderate keratoconus who are no longer managing well with contact lenses and who are not yet ready for corneal transplantation.

🔗 Learn more in our dedicated post:

CAIRS – Natural Corneal Ring Segments for Keratoconus

Implantable Contact Lenses (ICL)

In patients with stable keratoconus who are unable to achieve satisfactory vision with glasses or lenses, an implantable contact lens (ICL) can be used to correct residual refractive error.

ICLs are:

• Implanted behind the iris

• Ideal for patients with high degrees of myopia or astigmatism

• Often combined with prior cross-linking for long-term stability

Many patients who undergo CAIRS can later be considered for ICL to further improve uncorrected vision, especially for distance tasks.

Corneal Transplantation

When keratoconus has progressed to a point where scarring, thinning, or irregularity is too severe for other measures, corneal transplantation may be needed.

There are two main types:

• Deep Anterior Lamellar Keratoplasty (DALK) – preferred when the inner layer (endothelium) is healthy

• Penetrating Keratoplasty (PK) – full-thickness transplant, used when deeper structures are affected

Thanks to advances like CAIRS and cross-linking, many patients who would once have needed a more invasive transplant can now be managed more conservatively and with less risk.

Why Choose Dr David Gunn in Brisbane?

Dr Gunn is a fellowship-trained corneal surgeon and national leader in keratoconus management. He offers:

• Comprehensive diagnostics (Pentacam, topography, tomography)

• Expertise in CAIRS, cross-linking, ICL, and keratoplasty

• Multidisciplinary management with specialist optometrists

Coming to Brisbane for CAIRS Surgery

Patients from Brisbane, interstate, and across the Pacific region travel to see Dr Gunn for access to advanced keratoconus care. As the first to introduce CAIRS in Australia, his practice is a referral centre for complex cases. To learn more, see our blog post: Travelling to Brisbane for Your Eye Surgery

Ready to Take the Next Step?

If you’ve been diagnosed with keratoconus—or suspect you may have it—early treatment can preserve your vision and avoid invasive surgery later in life. Visit our keratoconus treatment page to learn more, or book a consultation with Dr Gunn to explore your options—including Australia’s most advanced keratoconus techniques.

DR DAVID GUNN - OPHTHALMOLOGIST

MBBS (Hons I), BSc, CertLRS, FRANZCO, FWCRS

Dr. David Gunn, a respected ophthalmologist based in Brisbane, specialises in managing corneal diseases, cataract surgery, and advanced laser and refractive eye procedures at the Queensland Eye Institute. He graduated with First Class Honours from the University of Queensland and was awarded the prestigious K.G. Howsam gold medal during his ophthalmology training.

As an innovator in his field, Dr. Gunn has a special interest in topographic laser eye surgery procedures. His introduction of the Corneal Allogenic Intrastromal Ring Segment surgery to Australia in May 2021 stands as testament to his drive for innovation, putting him among a select few surgeons worldwide performing this technique.

Beyond his clinical work, Dr. Gunn contributes to future developments in ophthalmology as a senior lecturer at the University of Queensland and through his active engagement in eye disease research.

However, what truly defines Dr. Gunn's work is his unwavering dedication to patient care. His pursuit of innovation and commitment to education all aim towards one goal: to enhance the lives of his patients through exceptional eye care. For Dr. Gunn, improving vision means improving life, a philosophy that continues to guide his practice in Brisbane.