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    Keratoconus

    There are a number of treatments available for Keratoconus, including glasses, contacts, corneal implants and corneal transplants, depending on the stage and severity of your condition.

    However, one verry innovative and highly effective treatment for Keratoconus is Corneal Collagen Cross-Linking. This treatment may be able to stop your vision from worsening, and has even been shown to improve vision in some people.

    The full name of the procedure is Corneal Collagen Cross-Linking with Riboflavin, also called CXL for short. It is used to strengthen the cornea in people with Keratoconus. In doing so, Corneal Cross-Linking can stop Keratoconus from worsening. It can also help flatten the central cornea in about 50% of patients, who often experience better vision as a result.

    The procedure is relatively simple and highly effective. It’s also very safe, and complications are extremely unlikely.

    What is Keratoconus?

    Keratoconus is a hereditary condition affecting the cornea (the transparent window at the front of the eye).

    Keratoconus occurs as a change within the structure of the cornea making it weaker and thinner, resulting in a ‘cone shaped’ forward bulge. It leads to myopia (short sight) and, if the steepening is uneven, also astigmatism. With Keratoconus, visual distortion can become difficult to correct with spectacles, although contact lenses (usually rigid) can provide more functional visual performance.

    At first, the protrusion occurs in the inferior parts (lower half) but later on it also affects the central part of the cornea.

    The Procedure

    Corneal Cross Linking is recommended for patients whose corneal scans show evidence of worsening Keratoconus, or those judged to be at especially high risk of worsening Keratoconus. As cross-linking naturally increases with age, the progress of Keratoconus usually stops by the mid-30s, so is not normally required for older patients.

    Cross linking is currently the only available treatment which appears to stop the worsening of Keratoconus. Clinical trials based on outcomes 1 year after cross-linking show success in the halting of Keratoconus in more than 90% of treated eyes, with more than 45% of eyes also gaining an improvement in corneal shape. A separate study over a 5 year period showed a similar success rate in halting the progress of Keratoconus. Visual improvement after treatment occurs in approximately 50% of cases. However, after treatment you will still need to wear spectacles or contact lenses.

    During the Cross Linking treatment our surgeons employ a combination of Riboflavin (Vitamin B) drops and ultra violet light that reacts with the collagen fibers in the cornea, strengthening them by creating more ‘cross-linking’ among them – and mimicking the natural corneal stiffening which occurs with age. The resulting increased strength of the cornea inhibits the progression of Keratoconus. The procedure is usually pain-free.

    Corneal Cross Linking will not reverse Keratoconus but in the majority of cases prevents the condition from worsening, and will, in some cases, achieve a visual improvement.

    1.What are the risks of Cross Linking?

    In general, cross linking is very safe, but you should allow time for your eye to heal and problems do occasionally occur. About 3% of patients will experience some loss of vision in the treated eye as a result of haze, infection or other complications. In most cases any visual loss can be reversed with a corneal transplant. Without cross linking treatment, at least 20% of all patients with Keratoconus will eventually require a corneal transplant.

    The treated eye is usually painful for 3 to 5 days, however levels of discomfort vary from patient to patient. Recovery time is about one week although most patients may find that it may be slightly longer.

    After treatment expect to take up to one week off work and for some patients who experience complications this could be longer. You will not be able to drive for at least a week.

    You might also experience severe light sensitivity after the treatment. It is important to rest as much as possible during these days to let the eye heal. If you partake in activities or sport, please ask your doctor when these may be resumed.

    Every patient is different, and your ophthalmologist will always recommend the appropriate Keratoconus treatment for you. This could include glasses, contacts, corneal implants or corneal transplant surgery.

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      Cataract

      A cataract is a cloudy or opaque area in the normally clear lens of the eye. Depending upon its size and location, it can interfere with normal vision.

      Most cataracts develop in people over age 55, but they occasionally occur in infants and young children or as a result of trauma or medications. Usually, cataracts develop in both eyes, but one may be worse than the other.

      The natural lens is located inside the eye behind the iris, the colored part of the eye. Normally, the lens focuses light on the retina, which sends the image through the optic nerve to the brain. However, if the lens is clouded by a cataract, light is scattered so the lens can no longer focus it properly, causing vision problems. The lens is made of mostly proteins and water. The clouding of the lens occurs due to changes in the proteins and lens fibers.

      Types of Cataracts

      The lens is composed of layers, like an onion. The outermost is the capsule. The layer inside the capsule is the cortex, and the innermost layer is called the nucleus. A cataract may develop in any of these areas. Cataracts are named for their location in the lens:

      • A nuclear cataract is located in the center of the lens. The nucleus tends to darken with age, changing from clear to yellow and sometimes brown.
      • A cortical cataract affects the layer of the lens surrounding the nucleus. The cataract looks like a wedge or a spoke.
      • A posterior capsular cataract is found in the back outer layer of the lens. This type often develops more rapidly.

      The Procedure

      Cataract surgery involves removing the natural lens of the eye and replacing it with an artificial lens. The artificial lens requires no care and can significantly improve vision. Some artificial lenses have the natural focusing ability of a young healthy lens. Once a cataract is removed, it cannot grow back.

      Two approaches to cataract surgery are generally used:

      • Small-incision cataract surgery involves making an incision in the side of the cornea (the clear outer covering of the eye) and inserting a tiny probe into the eye. The probe emits ultrasound waves that soften and break up the lens so it can be suctioned out. This process is called phacoemulsification.
      • Extracapsular surgery requires a somewhat larger incision in the cornea so that the lens core can be removed in one piece. The natural lens is replaced by a clear plastic lens called an intraocular lens (IOL). When implanting an IOL is not possible because of other eye problems, contact lenses and, in some cases, eyeglasses may be an option for vision correction.

      As with any surgery, cataract surgery has risks from infection and bleeding. Cataract surgery also slightly increases the risk of retinal detachment. It is important to discuss the benefits and risks of cataract surgery with our online consultans. Other eye conditions may increase the need for cataract surgery or prevent a person from being a cataract surgery candidate.

      Cataract surgery is one of the safest and most effective types of surgery performed in Turkey today. Approximately 90% of cataract surgery patients report better vision following the surgery.

      1.After Cataract Eye Surgery

      If the surgeon has administered medication to help you relax during the surgery, you may be a little groggy afterward and will usually be asked to rest in a designated recovery area for 30 minutes to an hour. A protective shield will be placed over the eye or eyes in which the surgery was performed, and your guide will help you get back to your hotel in our VIP car. Although many patients report experiencing clear vision just several hours after the surgery, others may not see results for several days to a week.

      Please feel free to reach out to us at your convenience on WhatsApp number +90542 512 5164 or fill out our online contact form to schedule a consultation if you’d like more information on how cataract surgery can enhance your quality of life.

      Cataract surgery is usually very quick. The procedure itself takes about a maximum of 20 to 30 minutes from start to finish.

      Although you’ll likely be awake during the procedure, it is not painful because you’ll be given a local anesthesia. You may experience slight discomfort, but intense pain is uncommon.

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        Excimer Laser

        Imagine not having to experience life from behind lenses. Imagine waking up in the morning, and starting your day without wrestling with contact lenses or hunting for your glasses. Imagine being able to wear prescription free sunglasses without having to fit them over your spectacles. These scenarios are all possible through the modern medical marvel of laser eye surgery.

        The world of laser eye surgery is attractive to many patients, providing clarity, convenience, and freedom from glasses or contacts. But like any surgery, not every procedure is right for every patient. There are three main corrective surgeries: LASIK, LASEK, and PRK. All three of these procedures are designed to reshape your cornea wih the use of the Excimer Laser. But all three of them vary quite a bit in terms of method.

        What is Excimer Laser surgery?

        Excimer laser surgery involves using a laser, which is computer controlled to reshape the cornea. The surgery is designed to treat imperfect vision or in other words, refractive errors.

        Until recently only myopia (short sight) and mild astigmatism (uneven shaped cornea, which is more steeply curved in one direction than the other) could be treated. However, thanks to improved laser technology, hyperopia (long sight) and more acute astigmatisms are now routinely treated.

        Our online consultants will advise if Excimer Laser surgery is suitable for you. Excimer Laser treatments may not be possible for patients with diabetes, rheumatoid arthritis or lupus (a disease affecting the immune system).

        The Procedure

        The Excimer Laser is a ‘cool’ type of laser. It doesn’t burn tissue, but vaporises small amounts of the cornea every time a beam of the laser is pulsed onto the surface of the eye. The diameter of the laser beam and the number of pulses that are directed onto the cornea are carefully controlled using computer technology, so that the surface of the cornea is reshaped.

        The procedure is performed using local anaesthetic eye drops and takes around 5 minutes per eye. However, the time taken for the reshaping of the cornea with the excimer laser is usually less than a minute.

        Different sight problems require different treatments. For example:

        • Myopia – the central apex or peak of the cornea must be flattened to reduce the degree of short-sightedness.
        • Long-sightedness – the central apex of the cornea needs to be made steeper. This is done by applying the excimer laser to the edge of the cornea.
        • Astigmatism – this occurs when the cornea is more curved in one meridian (or axis) than the other so the laser is applied to make the cornea more evenly curved.

        After a successful procedure, the cornea is able to focus light rays directly onto the retina at the back of the eye, rather than in front of or behind the retina.

        1.Why would a patient require laser eye surgery?

        The reason why most people choose to have laser eye surgery is that they find that the consequences of wearing glasses or contact lenses are very disabling or they have a huge negative impact on the quality of their lives.

        One of the most common reasons we see are people who do a lot sports. They find that wearing glasses is impossible due to either being outside and it being raining, or the fact that they do contact sports, it is just not safe to wear glasses.

        Other people who wear contact lenses find that they cannot swim with their contact lenses in because it is simply not safe to do that, or again they do contact sports and if there are any blows to the eye, there is a risk of either dislodging and losing the lens or, if it is a hard lens, of that shattering in the eye.

        Some other common reasons for people to have laser eye surgery are that they become intolerant to their contact lenses, so we have many patients, who have worn contact lenses for many years, but after a period the effect of wearing a lens on surface of the eye, causes the eye to become inflamed or uncomfortable, or simply for them to have gritty sore eyes at the end of a day of wearing contact lenses and that is a very common reason for people seeking laser eye surgery.

        Laser eye surgery is an attractive option to fix your vision because it is permanent. You can give up dealing with glasses and contact lenses with one quick and safe surgery. Most patients experience their new corrected vision by the day after the procedure. The recovery time is minimal.

        There are a few rare cases where vision could change after laser eye surgery. For example, if your genetics indicate that your vision may continue to change over the years. In that case, the one-time surgery will not prevent that from happening. However, this is an extremely rare occurrence.

        If your eyeglasses prescription has not been stable for at least a year your vision could also change after surgery. Patients must wait to have the procedure until after their prescription is stable.

        A more common type of vision change is the kind that can come with age. Patients may experience loss of near-sighted vision as they get older. If this happens, patients may qualify for Lens Replacement. This procedure helps people with an age of 50-plus see without reading glasses or varifocals.

        The good news is that for a vast majority of patients, laser eye surgery is permanent. They can live their life without worrying about glasses or contact lenses again.

        The recovery time following laser eye surgery varies depending on which type of laser eye surgery you have. With the first generation of laser eye surgery which is PRK or LASEK, the full recovery typically is one week and therefore we advise patients not to drive for at least a week. Some patients after LASEK can take longer to reach the driving standard but in general, the vision is entirely stable and has reached its pre-operative levels with glasses by one month after surgery.

        The visual recovery after LASIK and SMILE is far more rapid and these are the second and third generations of laser eye surgery.

        Typically by the following morning after surgery, i.e. the first day after surgery the patients can see 20/20 or close to it, and far exceed the legal standards for driving so usually the patients are cleared to go back to driving and back to work the day following surgery.

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          Scar Transplantation

          Hair transplant surgery is a well-known treatment for those suffering from male or female pattern baldness but it also has another important purpose. Those who have suffered permanent injury or disfigurement, because of an accident, surgery, congenital birth defect or fire for example, can also benefit from advances in hair transplant technology.

          Special attention and multiple procedures

          Hair grafts will grow in scar tissue, so it is perfectly possible to have a hair transplant performed over a scar.

          If the tissue is thickened or raised local steroid injections may help to flatten it, but once the scar is smooth the transplant can be performed as normal.

          However, areas of scar tissue can have a reduced level of blood supply compared to normal areas of the scalp. This means that the grafts should not be placed too close together, otherwise growth can be poor.

          Instead, the doctor will need to leave larger gaps than normal between grafts, and as these grow, new blood vessels will form in the area. The patient can then undergo further transplant procedures, adding extra grafts to achieve more density in these areas and a natural looking final result.

          At My Imperial Care we have a successful record of performing hair transplants on patients with scar tissue, often resulting from previous procedures performed with older techniques.

          The Procedure

          When you receive a hair transplant to cover scars, our doctors usually work with quite small areas. They shave a small square in the donor area in the back of the head and extract grafts. These grafts then move to the area of scar tissue to be hidden. The hair transplant is then supplemented with a PRP treatment for best results. Sometimes the scar tissue may be so thick that PRP treatment is needed before the procedure to encourage blood supply to the area.

          Different types of scar transplants:

          • Hair transplants to hide the scars on the head.
          • Hair transplants to conceal scars on the face.
          • Hair transplants to hide scars over the eyebrows.

          We are also visited by patients who want to correct scars from previous hair transplants using older and inferior techniques, which have created scars in the donor area. It is never possible to completely hide the scars by moving hair follicles to the scar tissue, but in almost all cases it is possible to significantly reduce the characteristically white scar.

          1.Can I have a hair transplant following a poor transplant or a FUT procedure?

          30% of Hair Transplant patients that we see require scar repair for scars left after having a poor hair transplant treatment elsewhere or from a previous FUT strip procedure.

          DHI and FUE hair transplants are a great way to help disguise previous hair restoration scars but it is a highly skilled technique which will require an in-depth examination of the scalp.

          A hair transplant for scar repair can be affected by:

          • The thickness of the scar
          • Inflammatory conditions
          • The blood supply to the scar

          It is possible to transplant hair follicles into scar tissue however there are risks associated with this such as a reduced blood supply. Hair follicles need a good blood supply to survive. If the blood supply is limited the hair follicles will not survive.

          A consultation with one of our online consultants is vital. You will be asked about your medical history. For example if you have an inflammatory disease then we would recommend that you do not have further hair restoration surgery until the disease has been inactive for at least 2 years. A flare up could result in the results of your surgery being compromised so keeping your condition under control is vital.

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            Hair Restoration

            A good hair transplant result is undetectable not only to another viewer but even to another hair-transplant surgeon. There are many reasons for a hair transplant to look unnatural and require a corrective procedure. Sometimes, it can be due to the use of old technology, progression of hair loss, or poor technique. For example, large round “plugs”, scalp reductions, and/or flaps were the procedure of choice in the past but with the progression of hair loss their results became unnatural. Sometimes the transplanted area looks unnatural and sometimes the donor area is left with wide scars and at times unnatural hair patterns that may be difficult to correct. Even though plugs and large reductions may not be performed anymore, the results of hair transplants can still look unnatural.

            Common mistakes associated with hair transplants

            With hair restoration becoming more and more popular, many surgeons and medical practices seek ways to capitalize on this revenue stream – even ones who may not have the experience or skills required to successfully perform hair transplants. In other cases, hair restoration clinics may perform hair transplants using a rotating staff of surgeons and support teams, rather than using one surgical team to perform the surgery from start to finish. Common mistakes include unskilled removal of hair follicles from the donor site, which can result in scarring or uneven patches, and unnatural or unsuitable placement of the hair grafts. In some cases, grafts are placed so poorly that new hair growth does not occur.

            When it comes to hair restoration surgery, the best results are achieved when a highly skilled and experienced hair restoration surgeon performs the surgery from start to finish. This helps prevent errors when the hair grafts are harvested from the donor site and when they are transplanted to their new location. Unfortunately, some surgeries are still done with little experience and poor technical expertise. The result of an hair transplant through these clinics can thus be very disappointing. Therefore, it is always important to not only focus on the price, but also on the skills and expertise of the medical team. Natural and aesthetically pleasing outcome depends upon a surgeon’s ability to reproduce the patient’s natural hairline.

            The Procedure

            Thanks to many years of experience performing hair transplants, our surgeons are able to easily identify what has gone wrong during a primary hair transplant. They then create a plan to correct these mistakes so they can craft a more natural outcome for the patient. Once the errors have been identified and a plan created, the corrective hair transplant is performed similarly to any other hair transplant performed by our surgeons.

            • The first step involves harvesting hair grafts from the donor site. One ofour surgeons will take special care to preserve the integrity of the scalp in the donor area and, if necessary, will work to address any scarring that occurred during the primary hair transplant. Harvesting is usually done using Follicular Unit Excision technique. The final approach used will depend upon the patient’s unique needs and the condition of the donor site.
            • Next the hair grafts are carefully prepared for transplantation.
            • Finally the hair grafts are individually placed in the recipient site, with special attention given to the angle of placement, density, pattern and hairline shape.

            Our surgeons and their respective medical teams manage the entire process from start to finish, helping to ensure a more consistent, natural result.

            1.Ideal candidates
            • Men who have unnatural results from a hair transplant or flap-rotation procedure
            • Women who have unnatural results from a hair transplant or hairline-lowering procedure
            • Contact our online consultants on Whatsapp number +90542 512 51 64 and schedule your procedure and plan on one week for recovery during which time you are functional but may not be socially presentable for several days.
            • If your plan for restoration includes beard harvesting, avoid shaving for 48 hours prior to the procedure. It is important to keep your beard at a specific length (no longer than 1 to 2 mm or a 2 day growth).
            • If you color your hair regularly, you are recommended to color it 2 to 3 days prior to your procedure. You will be allowed to recolor it 2 weeks after the procedure.
            • Since you are flying in from abroad, you will be required to arrive the day before the procedure and will be allowed to travel the day after, staying in Antalya for a total of two nights.
            • You can wear a hat after the procedure, and you can wash your hair 24 hours after and travel the next day.
            • Transplanted hairs should start growing as early as 3 to 4 months post-procedure (but may not have any substantial growth for a few months after that period) and should improve in growth up to 12 months post-procedure or longer.
            • Corrective surgeries can be done in stages or your restoration design may include a second procedure. Depending on hair growth and the area that needs to be restored, you may plan your second procedure as early as 6 months afterward and ideally 10 to 12 months after your first procedure.
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              PRP Hair Treatment

              The PRP (Platelet-Rich Plasma) technique utilizes the reconstructive and regenerative substances needed for our skin to flourish and for the healing process to be faster. PRP is used to help the body heal itself after various surgeries and has now become widely used in the field of cosmetic surgery. Not only does it work on scars, wounds, cracked or damaged skin, but it also helps in the regrowth of hair.

              For this reason, PRP now also plays a big role in hair loss treatments. Once the transplant is completed, PRP is used in the areas that need regeneration and stimulation the most. PRP is used to help in the healing process of the affected areas, to stimulate growth in those areas, and to revitalize weakened hair.

              Why is the PRP method used for hair treatments?

              The PRP hair treatment is an innovative method to combat hair loss or thinning due to androgenetic alopecia. It helps prevent hair loss and strengthen weakened hair.

              PRP is used in all hair transplant surgeries carried out by our surgeons in order to enhance the results of the hair transplant. The treatment helps the post-operative healing process and positively influences hair regrowth and thickness after transplant.

              The Procedure

              • A small amount of blood is obtained from the patient.
              • Platelet-Rich Plasma is isolated following the centrifugation of blood.
              • PRP is activated with DNA activators (thrombin) and enriched with calcium ions (e.g. calcium chloride).
              • Activated PRP is injected into the area which is suffering from hair loss in order to stimulate hair growth.

              Platelet-Rich Plasma (PRP), can be used as an individual treatment, primarily to fortify the hair follicle, thus ensuring it´s longevity and viability as well as maintenance and conservation of the existing hair, but also to reinvigorate dormant hair follicles and stimulate growth of newly transplanted hair.

              Moreover, PRP can be coupled with any hair transplant procedure, helping partially transected follicles from the donor area; regenerate bristles and also helping the hair follicles in the recipient areas to enhance the development of new hair.

              The PRP hair restoration process involves centrifugation of the blood from the patient, which is sampled prior to the hair implantation procedure. With a special kit our surgeons are then able to use the plasma enriched growth factors and cytokines (proteins growth) in order to strengthen and improve the longevity of the hair follicle.

              1.Benefits of PRP in Hair Transplantation

              There is a growing percentage of positive evidence from many researchers, who suggest that PRP provides significant advantages for treatment of hair loss and can be used in modern day hair restoration surgery. Numerous independent studies have shown promising results when PRP is combined with hair implantation such as:

              • Reduces erythema (redness and irritation)
              • Reduces the formation of crust or scabbing
              • Reduces trauma and inflammation
              • Reduces patients discomfort and speeds up the healing phase
              • Accelerated growth of hairs when PRP is applied
              • Increased size of follicles per unit
              • Increased longevity of already existing hairs

              Men and women who are experiencing hair loss or have thinned hair, mainly those with androgenetic alopecia are suitable candidates for this treatment. PRP treatment is not suitable if you have been diagnosed with cancer, thrombocytopenia (low blood platelet count), chronic liver disease or if you are on blood thinning medication.

              This will depend on the patient but we recommend at least 3 to 8 sessions with a minimum of 15 days in between each session.