Treatment packages are mainly leveled based on the ranking of surgeons (according to the number of annual surgeries, years of experience, educational and experimental records, the rate of successful surgeries and the percentage of patients’ satisfaction) and the hospital/clinic where the surgery is performed.
Corneal disease is the fourth most common cause of blindness, after cataracts and glaucoma, affecting more than 10 million people worldwide. The American Eye Association estimates that more than 47,000 corneal transplants were performed in the United States in 2013, and since 1976, more than one million people have had their vision restored through corneal transplants.The cornea is the transparent layer in front of the eye which is directly opposite the iris of the “colored part of the eye”. In fact, the color of the eye depends on the iris, which varies from person to person, but the cornea is completely transparent like a window and allows light to enter the eye. It also redirects the cornea so that images of distant and near objects are focused on the retina. Therefore, the transparency of the cornea is very important in vision. The light beam that passes through the damaged cornea may be distorted and affect your vision. If this part is damaged, it may need to be replaced. Corneal transplantation, also called keratoplasty, is an eye surgery in which a patient’s damaged cornea or injured tissue is replaced with a donated cornea instead of part or the entire cornea. This type of transplant can be performed in diseases such as keratoconus, inflammation and injury, corneal degeneration or corneal opacity. Keratoplasty can reduce pain, restore vision, and improve the appearance of the cornea if it becomes white and sore. Corneal transplantation should be performed by an ophthalmologist.The new cornea belongs to the people who donated the tissue at the time of death from the eyes of people who have expressed a desire to donate cornea to others before death or whose family agrees. The important point is that the cornea is made from a person who has a known disease or a characteristic that does not cause the cornea to recede. Donated corneas in the eye bank are carefully examined to ensure their health. In addition, all transplanted corneas are screened for diseases such as AIDS and hepatitis so that these diseases do not spread to the recipient. These corneas are then kept in the eye bank to be given to the person in need.
Corneal transplantation may be necessary if prescription glasses or contact lenses are unable to restore your vision or if painful swelling is not relieved by medication or special contact lenses. These are other symptoms that may show someone needs corneal transplant surgery. Corneal scarring caused by injury or infection Wounds or “scratches” of the cornea caused by infection Cases of hereditary conditions A clinical condition that causes the cornea to protrude (keratoconus) Thin, cloudy or swollen cornea Hereditary eye diseases, such as Fox dystrophy and others Problems caused by old eye surgeries
Different Types of Corneal Transplantation (keratoplasty) Surgery
Corneal transplantation is performed in two ways:
Creating better vision in cases where corneal opacity has caused blurred vision. Corneal repair to protect the structures inside the eyeball. Treatment of eye pain in cases that there is severe pain due to disease or swelling of the cornea. Eradicate the infection in cases where the corneal infection is not treated with medication
Generally, for corneal transplantation, tests and examinations are performed first by an ophthalmologist. Once the transplant is approved, it is necessary for the patient’s corneal reservation to be coordinated by the eye bank before the patient is admitted so that a proper cornea is available during the operation.Corneal Transplantation (keratoplasty) surgery is done very carefully with the help of microscopic devices. The eye surgeon performs general anesthesia depending on the patient’s health, age, eye injury or disease, and if the patient wishes. In special cases and due to diseases such as heart or lung problems, local anesthesia can be performed with sedative injections or hypnosis.If local anesthesia is used, the injection will be given into the skin around the eye to control the eye muscles for blinking and eye movement, so drops will be used to numb the eye. Patient will be conscious during this method and most people will not feel uncomfortable in this method. After local anesthesia, a device called a door splint is used to keep your eyelid open. The surgeon will then examine the donated tissue after examining the thickness of the cornea.The procedure takes approximately one to two hours. During a full-thickness corneal transplant, the surgeon uses a microscopic instrument to remove a round piece from the center of the patient’s cornea and instead inserts a round piece that fits the donor’s healthy cornea and sews it with many delicate stitches to the patient’s eye. For layered corneal transplantation, the damaged layer of the patient’s cornea is removed using very fine knives or automatic knives (microkeratoms) and instead, a suitable layer of the healthy cornea of the transplant recipient is placed. With the development of femtosecond laser technology, in many cases of corneal layer transplantation, this type of laser is used to cut and prepare the desired layer of the cornea. Since wound healing in the area of corneal transplantation takes a long time; the stitches should remain in place until the wound is completely healed (usually several months). At the end of the operation, the eye is bandaged. Usually after the operation, when the patient regains consciousness, he/she feels pain and discomfort, which is normal and should not cause concern. Finally, a plastic shield or gauze is placed over the affected eye for up to four days to protect it during recovery. Corneal Transplantation (keratoplasty) Surgery is outpatient procedures, meaning patient can go home after surgery. but for 3 to 4 weeks it is necessary to be examined by a doctor once every few days.
v Take a shower the day before the operation and it is better for men to shave their face.v On the day of surgery, women should avoid makeup, especially eye makeup.v Be sure to take all the medications that you have taken due to other diseases such as diabetes, blood pressure, heart disease, etc.v No eating and drinking after midnight on the night before surgery.v Wearing loose, comfortable clothing on the day of the procedure.
Immediately after a corneal transplant, the eye is very sensitive to trauma and may be seriously injured, even with minor trauma. Therefore, in the first weeks after the transplant, it is necessary to use a plastic shield to prevent eye damage. The day after the operation, the eye dressing is opened and the eye is examined. On the first day after surgery, vision is blurred. Blurred vision improves gradually, so you should not expect good vision in the first days and weeks after surgery. Pain, tenderness, and tearing of the eye usually improve after 3 to 4 days.
In fact, corneal transplantation is the most successful operation among tissue transplants. Corneal transplantation is considered a completely safe procedure, but it is a surgical procedure, so it carries risks. The complications of corneal transplantation are significant and can include corneal transplant rejection, eye infections, and stiches problems.Donor tissue rejection is the most serious complication after corneal transplantation and occurs in 5 to 30% of patients. In about 1 in 10 transplants, the immune system recognizes and attacks the cornea as an external organ and tries to destroy the connective tissue. This is called graft rejection and is most often reversible with eye drops.Research shows that having glaucoma and corneal swelling associated with cataract surgery can increase the risk of corneal transplant rejection.Redness, severe sensitivity to light, decreased vision, and the pain are the main warning signs of corneal transplant rejection that may appear early in the first month or a few years after surgery. Your ophthalmologist will prescribe medications that can help reverse the rejection process. If diagnosed early, 9 out of 10 transplants will be successful and if your transplant fails, the corneal transplant can be repeated. Most people who have a corneal transplant regain at least part of their vision, but this varies from situation to situation. Complete recovery of vision may take several weeks to a year. Vision may get a little worse before it gets better.Because connective tissue is not completely round, you may need glasses or contact lenses to correct astigmatism. Mild refractive errors due to corneal transplant surgery can be corrected with glasses. Otherwise contact lenses are required. Hard gas-permeable contact lenses, also known as RGP or GP lenses, and hybrid contact lenses are the best choice for corneal transplant patients due to irregular cornea after transplantation. However, soft contact lenses are also often a viable option. Mild refractive errors due to corneal transplant surgery can be corrected with glasses. Otherwise contact lenses are required.Because vision will fluctuate during the first few months after your surgery, it is advisable to wait until your ophthalmologist tells you that your vision has stabilized before prescribing glasses or contact lenses. After your eye has completely healed and all the stitches used have been removed, you may be eligible for laser eye surgery such as LASIK or PRK to improve your ability to see with or without glasses or contact lenses.
Iran has a vast potential in eye treatments and corneal transplantation surgery in Iran is a procedure that is performed for more than a century with the most modernized and developed technology by professional specialists. More than 7,000 corneal surgeries are performed in the country per year. Femtosecond laser and artificial cornea are among the newest corneal transplantation methods used in the world, which have also been tailored by the Iranian surgeons in the recent decade.
Corneal Transplantation or keratoplasty surgery in Iran is more affordable than anywhere in the world In terms of costs, while; it is considerably lower than clinics in the UK, the US (ranges from $13,000 to $27,000 without health insurance and 9,000$ to 11,000$ with health insurance) or neighboring countries in the region. The eye transplant cost in India can range from 7000 to 12,000 USD, which is extremely affordable when compared to the cost of the US and the UK hospitals. One of the most important factors for choosing a good surgeon at corneal transplantation (keratoplasty) surgery in Iran is the doctor has done many corneal transplantation surgeries. Whereas, a reliable medical tourism destination like Iran can remove all worries about qualifications of the surgeon and related services, a corneal transplantation surgery cost in Iran is approximately $2,100 to $4,200 and it and raises to 12,000$ for the most complicated cornea transplant which is extremely affordable when compared to the cost of the US, UK, and even other Asian countries. This cost mainly includes doctor visits, clinic, anesthesia, medications, post-op recovery, follow-up, etc. Depending on the doctor’s reputation and level of expertise, the complexity of the procedure, and clinic, the price may vary.
It should be noted that individual brochures based on the patient / client plan, including pre- and post-operative instructions, as well as the necessary information and processes for further follow-up are provided to you. During your stay in Iran, the translators of Nora Health Tour fully support you 24/7 and will happily help you to resolve any concerns or ambiguities that may arise for you.
In addition to the cornea, other parts of the eye, such as the sclera or the white part of the eye, are used in some types of surgery.
Some surgeries use artificial corneas, which are difficult to use and are still being researched. There are perhaps 400 or 500 such surgeries performed worldwide each year. This method is used when it is not possible to use a donated cornea, for example, some people who have severe scar tissue in the eyeball and the eyelid does not open and close naturally. In this case, an artificial cornea can be used. . There are new prostheses designed to replace damaged corneas, but nothing is as useful as donated human corneas.
You will spend about one to two hours in the operating room performing corneal transplant surgery, but it will take less time to perform the operation yourself.
After a corneal transplant, your eyes will likely become red and inflamed and sensitive to light, and you may experience tears and a slight discharge. The pain and discomfort of the operation will usually be controlled in the first few days after surgery with painkillers such as Tylenol or other brands such as acetaminophen.
Most people use stitches, but most likely will not notice them at all. Some stitches are removed one month after surgery, but others last up to a year.
After the operation, you will need to use eye drops and sometimes use eye ointment to prevent inflammation and infection of the transplanted tissue.
Your doctor will talk to you about the limitations of exercising. You should avoid doing activities that directly touch your eyes, such as soccer and the like.
If your other eye can see enough to drive, you can drive after twenty-four hours when the anesthetic wears off. Your doctor may ask you not to drive for a few days after the operation. Remember that someone must be with you to take you home from the hospital and take you to the doctor’s office the next day for the necessary examinations.
There is always the possibility of reversing a corneal transplant, and the possibility of reversing it at any time, even a few years after the corneal transplant, is raised, so you should be familiar with the signs and symptoms of corneal transplantation. If the corneal transplant is rejected, the corneal transplant can be performed again and good results can be obtained, but the rate of rejection of the second transplant is slightly higher compared to the first transplant.
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