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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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