Can I Be Asleep for CAIRS Surgery?

Short answer: yes. And for a lot of my patients, it’s the answer that turns “I can’t face this” into “let’s book it.”

Plenty of eye procedures around the world are done wide awake under local anaesthetic drops, and if you’ve been researching CAIRS for keratoconus, you may have read exactly that and quietly started dreading it. The thought of being awake while someone operates on your eye is, for many people, the single biggest barrier to going ahead. So let me be clear about how I do it.

Sound asleep, start to finish

I perform CAIRS in an accredited day hospital with a specialist anaesthetist looking after you. You’ll be sound asleep for the entire procedure.

Technically, it isn’t a general anaesthetic. It’s heavy sedation, which for you means the best of both worlds: you’re asleep the whole time and will remember nothing of the procedure, but you avoid the deeper commitment of a full general anaesthetic and tend to wake up quicker and more comfortably. From your side of the experience, the distinction hardly matters. You drift off, and the next thing you know it’s done.

Who this matters most for

Two groups, in my experience.

Nervous patients. If you’re anxious about eye surgery, you’re not unusual — you’re the majority. Eyes are different from knees; people who’d happily have any other operation go pale at the idea of watching one happen to their own eye. Being asleep removes that problem completely. There’s nothing to watch, nothing to hear, nothing to remember.

Teenagers and younger patients. Keratoconus is a disease of the young, and it often progresses fastest in the teenage years, which means the patients who most need treatment are often the least equipped to lie perfectly still under an operating microscope while awake. With an anaesthetist and proper sedation, a 15-year-old’s CAIRS procedure is a non-event: they’re asleep before anything happens and awake when it’s over. For parents, that’s usually the moment the whole decision gets easier.

What the day looks like

You’ll come in to the day hospital, meet the anaesthetist, and be asleep before the procedure starts. When you wake in recovery, it’s done. You’ll have something to eat and drink, be checked over, and go home the same day with someone to drive you. From there, the week-by-week recovery guide tells you exactly what to expect: a sore eye for four to six hours, a few days of tenderness depending on segment size, and three to four days off work for most people.

If you’re wondering whether the same applies to other procedures: it does. I’ve written before about being asleep for cataract surgery, and the philosophy is identical. Fear of being awake should never be the reason someone misses out on treatment they need.

The bottom line

You can be asleep for your CAIRS surgery. Sound asleep, with a specialist anaesthetist, in an accredited day hospital, remembering nothing. If anxiety about the procedure has been holding you back, or you have a teenager who needs treatment and is frightened of it, that barrier doesn’t exist here.

The CAIRS treatment page covers the procedure itself, the long-term results post covers how well it holds up over a decade, and if you’d like to talk it through, book a consultation — the conversation is a lot less scary than the internet makes the surgery sound.