Cornea Transplant (Keratoplasty): Open a Clear Window to Life Again!

The cornea, the transparent and curved layer at the very front of our eye, like a watch glass, is a vital structure that allows light to enter our eye and focus clearly. However, due to various diseases, infections, injuries, or genetic disorders, the transparency of the cornea can be impaired, its shape can become irregular, and this can lead to serious vision problems, even blindness. Corneal transplantation (Keratoplasty) is a microsurgical operation aimed at restoring or significantly improving vision by replacing damaged or opaque corneal tissue with healthy corneal tissue from a donor. This is an extremely delicate and specialized treatment method that opens the doors to hope and renewed vision. Estebox Istanbul, with Turkey’s advanced expertise in eye surgery and well-equipped centers, offers you accurate information, reliable guidance, and comprehensive support for specialized treatments like corneal transplantation.

What is the Cornea? Why is This Transparent Shield of Our Eye So Important?

The cornea is the outermost layer of the eye, acting like a window that allows light to reach the inner parts of the eye. It is also the most important refractive lens of the eye; meaning it helps to refract light to form a clear image on the retina. Loss of transparency and smooth surface of the cornea causes light not to be refracted properly, resulting in blurred, distorted, or reduced vision.

In Which Situations Does Corneal Transplantation Become a Necessity?

Corneal transplantation is generally considered when other treatment methods (medication, glasses, contact lenses) are insufficient and the damage to the cornea seriously threatens vision:

• Keratoconus: A progressive disease characterized by the cornea conically bulging pTM and thinning. Corneal transplantation may be necessary in advanced stages.
• Corneal Dystrophies: Clouding or opacification in different layers of the cornea due to genetic reasons (e.g., Fuchs’ dystrophy).
• Corneal Scars (Scar Tissue): Permanent cloudiness and scars on the cornea resulting from infections (herpes, bacterial keratitis, etc.), trauma, or chemical burns.
• Opacification After Corneal Ulcers: Loss of transparency when treatment-resistant or deep corneal ulcers heal.
• Corneal Damage After Unsuccessful Eye Surgeries: Rarely, permanent edema or damage may develop in the cornea after previous eye surgeries (e.g., complicated cataract surgery).
• Corneal Perforations: Emergency transplantation may be required if the cornea is perforated due to trauma or severe infection.

Types of Corneal Transplants: Special Solutions According to the Extent of Damage

Corneal transplantation can be performed with different techniques, depending on whether only the damaged corneal layer or the entire cornea is replaced:

1. Full-Thickness Corneal Transplant (Penetrating Keratoplasty – PKP): This is the oldest and most common technique where all layers of the cornea (approximately 0.5 mm thick) are removed in a circular manner and replaced with a full-thickness healthy corneal tissue of the same size from a donor, which is then sutured. It is generally preferred when all layers of the cornea are affected.
2. Partial-Thickness (Lamellar) Corneal Transplant: These are newer and more advanced techniques where only the diseased layers of the cornea are replaced, while the healthy layers are preserved. This can reduce the risk of tissue rejection, speed up healing, and achieve better visual results.
3. DALK (Deep Anterior Lamellar Keratoplasty): The front and middle layers of the cornea are replaced while the innermost layer, the endothelium, is preserved. It is particularly preferred in conditions like keratoconus where the endothelium is healthy.
4. DMEK (Descemet Membrane Endothelial Keratoplasty) / DSAEK (Descemet Stripping Automated Endothelial Keratoplasty): These are techniques where only the diseased innermost layer of the cornea, the endothelium, is replaced. They are applied especially in cases of endothelial insufficiency such as Fuchs’ dystrophy. They are performed through very small incisions, and recovery is quite rapid.

Your ophthalmologist will determine the most suitable transplant technique for you based on the type, depth, and extent of damage to your cornea.

Corneal Transplant Operation: A New Door Opening to Vision

Corneal transplantation is an extremely delicate microsurgical operation that requires special expertise and experience in this field:

1. Detailed Eye Examination and Preparation: A comprehensive examination of your eyes is performed before the operation. Many measurements such as corneal thickness, curvature, and cell count are taken. Your general health condition is evaluated. Donor corneal tissue is obtained from eye banks and tested for suitability.
2. Anesthesia: The operation can usually be performed under general anesthesia or, in some cases, local anesthesia (an injection around the eye or just drops).
3. Surgical Procedure: The surgeon, using special microsurgical instruments and an operating microscope, removes the diseased corneal tissue and replaces it with healthy corneal tissue from a donor, fixing it with very fine sutures (usually 16 or more) or special techniques (with an air or gas bubble in DMEK/DSAEK).
4. Operation Duration: It usually lasts between 1 to 2 hours.

After Corneal Transplant: A Process Requiring Patience, Care, and Regular Follow-up

The recovery process after corneal transplantation is generally longer and requires more attention compared to other eye surgeries:

• Hospital Stay: You may usually need to stay in the hospital for 1 night after the operation.
• First Days and Weeks “Protection and Medication”: You will have a bandage or a protective shield on your eye. Pain, stinging, watering, sensitivity to light, and blurred vision are normal. It is vital to use the antibiotic, cortisone, and artificial tear drops prescribed by your doctor regularly and meticulously to prevent infection, prevent tissue rejection, and support healing. You must strictly avoid rubbing your eye, impact, and getting water into it.
• Visual Recovery “Gradual and Long-Term”: Visual acuity gradually increases after the operation. In full-thickness corneal transplantation, sutures usually remain for 6 months to 1 year, sometimes longer, and vision may fluctuate during this period. Vision may stabilize earlier after sutures are removed or after lamellar keratoplasty.
• Risk of Tissue Rejection “Lifelong Attention”: There is a risk that the body may perceive the transplanted corneal tissue as foreign and react against it. This risk is higher, especially within the first year, but can continue. If symptoms of tissue rejection such as redness, pain, blurred vision, or sensitivity to light are noticed, a doctor should be consulted immediately. Tissue rejection can usually be treated with early intervention.
• Astigmatism and Need for Glasses: High astigmatism may develop after corneal transplantation, and glasses or contact lenses may be required to achieve clear vision. In some cases, additional laser treatments or relaxing incisions may be performed to correct astigmatism.
• Regular and Long-Term Follow-ups: Lifelong regular ophthalmologist check-ups after corneal transplantation are very important for monitoring the health of the transplanted cornea, visual acuity, and intraocular pressure.

Why Turkey for Corneal Transplant? Rediscover the Value of Sight with Estebox Istanbul!

Turkey has internationally recognized, experienced ophthalmologists who perform these complex and specialized operations with high success rates, and eye hospitals and eye banks with advanced technology in the field of corneal diseases and corneal transplant surgery. Istanbul is a center where important surgeries like corneal transplantation, which directly affect quality of life, are performed with the most current surgical techniques (including DALK, DMEK, DSAEK) and a patient-oriented perspective.

As Estebox Istanbul, we offer reliable consultancy and comprehensive support services to our patients who are at risk of losing their vision due to corneal problems or whose quality of life has severely declined, to help them access Turkey’s expertise and facilities in this field. We work with ophthalmologists specializing in their field with deep experience and international recognition in corneal surgery, JCI-accredited, fully equipped eye hospitals and clinics with all necessary infrastructure for corneal transplantation (including eye bank connections). From detailed pre-operative medical evaluation, coordination for obtaining suitable donor tissue, your travel, accommodation, and hospital arrangements in Turkey, to your long-term post-operative follow-up process, we are with you every step of the way. Our aim is to transform your corneal transplant experience in Turkey into a hopeful, safe, and successful journey that helps you regain your vision.

Corneal Transplant Prices in Istanbul: A Valuable Step to Regaining Sight

The cost of a corneal transplant operation varies depending on many important factors such as the type of transplant technique to be applied (full-thickness, DALK, DMEK/DSAEK), the cost of obtaining donor corneal tissue (eye bank fees), the surgeon’s experience and expertise, the technological infrastructure and service quality of the hospital where the surgery will be performed, the length of hospital stay, post-operative medications to be used, and the scope of follow-up services. This is generally a more costly process compared to other eye surgeries.

However, corneal transplant prices in Turkey are generally more competitive and accessible compared to similar quality highly specialized and comprehensive healthcare services in Europe, the UK, and the United States. This means you can access this important operation, which will change your life, with a more affordable budget without compromising on quality, safety, expertise, and advanced technology. Estebox Istanbul organizes a detailed pre-assessment and expert doctor consultation to offer you a treatment plan tailored to your specific medical condition, type of corneal disease, and expectations, and transparent pricing accordingly. Please do not hesitate to contact us to get clear information about the cost of your corneal transplant operation and to benefit from our free consultation service.

What You Need to Know About Corneal Transplant: Frequently Asked Questions (FAQ)

Q: How is donor cornea found for a corneal transplant?

A: Donor corneal tissues are obtained from deceased individuals, with the consent of their families, by preserving the donated corneas under sterile conditions in special eye banks and subjecting them to suitability tests. Patients waiting for a corneal transplant are registered on national or regional waiting lists.

Q: What is the risk of tissue rejection after a corneal transplant? How is it prevented?

A: Tissue rejection is a reaction of the body perceiving the transplanted cornea as foreign. This risk is higher, especially within the first year, but can continue जीवनभर. To prevent or treat tissue rejection, cortisone and other immunosuppressive eye drops are used for a long time after surgery. In lamellar keratoplasty techniques (DALK, DMEK/DSAEK), the risk of tissue rejection is generally lower compared to full-thickness corneal transplantation.

Q: When will I start to see clearly after a corneal transplant?

A: Visual recovery is gradual and varies depending on the technique applied. In full-thickness corneal transplantation, it may take up to 1 year to achieve full clarity due to sutures. In endothelial transplants like DMEK/DSAEK, vision usually improves significantly within a few weeks.

Q: Will I need to wear glasses after a corneal transplant?

A: Yes, some degree of refractive error (myopia, hyperopia, astigmatism) usually remains after corneal transplantation, and glasses or contact lenses may be required to achieve the best vision. In some cases, additional laser treatments or relaxing incisions can also be applied to correct these refractive errors after the sutures are removed.

Q: How many times can a corneal transplant be performed?

A: If the first corneal transplant fails or becomes cloudy again over time, a second or even a third corneal transplant can be performed. However, with each repeat transplant, the risk of tissue rejection and the chance of success may decrease.