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Corneal transplantation (penetrating keratoplasty) in Iran is a surgical operation during which the damaged area of ​​the patient's cornea is replaced with a donor graft. A transplant can significantly improve vision in diseases that affect the cornea and restore the damage caused by eye injuries. The operation is usually performed under general anesthesia.

Each month, over 40,000 Iranians, as well as international patients undergo corneal transplant surgery in Iran. With the best specialists and surgeons in the middle east, Iran's corneal transplantation is outstanding in the region.

Corneal transplantation consists of Keratoplasty (the replacement of all layers of the cornea and selective keratoplasty (the replacement of specific layers of the patient's cornea - anterior or posterior). The cornea is a relatively simple tissue and does not contain blood vessels, so the donated site takes root ideally in most cases. At an early stage of engraftment, antimicrobial therapy is prescribed, and glucocorticoids are instilled to prevent a possible rejection reaction. A few months after the transplant, the sutures are removed from the eye. Still, the patient is advised to avoid heavy physical activities.

 

Penetrating keratoplasty

Indicators:

  • Corneal scars after various injuries
  • Corneal opacities after keratitis and corneal ulcers of various etiologies
  • Corneal ulcer with perforation threat
  • Hereditary corneal dystrophies
  • Secondary corneal dystrophy (after surgical interventions, injuries)
  • Belmo cornea
  • Advanced stage keratectasia (keratoconus, transparent marginal degeneration, keratoglobus)

 

In end-to-end transplantation, the patient's defective cornea is cut out in the form of a disk of a specific diameter using a special trephine, after removing all layers of the cornea the patient's cornea is replaced with a similar disk of a donor graft.

Deep anterior lamellar keratoplasty

Indicators:

  • Advanced stage keratoconus
  • Superficial scars and corneal opacities

 

When performing deep anterior layered keratoplasty, the anterior layers of the cornea are replaced, and its posterior layers (the layer of endothelial cells and Descemet's membrane) remain intact. This type of keratoplasty is applicable in cases where the pathology does not affect the deep layers of the cornea.

Similarly, with penetrating keratoplasty, a damaged corneal disk of a specific diameter is cut out, replaced with a donor graft, and fixed with a corneal suture.

The advantages of anterior deep lamellar keratoplasty are a reduction in the risk of graft rejection and the risk of intra- and postoperative complications.

 

Endothelial keratoplasty

Indicators:

  • Hereditary corneal dystrophies with damage to the posterior layers
  • Secondary endothelial dystrophy of the cornea
  • Endothelial decompensation of a corneal graft after keratoplasty

Before the 21st century, the primary method of treating corneal endothelial dysfunctions was penetrating keratoplasty. Still, with the development of technology, it became possible to perform selective transplantation of only the posterior layers of the cornea, which are involved in the pathological process. Posterior layered keratoplasty replaces the damaged layer of endothelial cells with a thin disk of the donor cornea.

At the first stage of the operation, the patient's endothelial layer and Descemet's membrane are removed through a small incision in the cornea.

Another transplant is cut out from the prepared donor material, a thin disk of corneal tissue - endothelium (layer of endothelial cells), Descemet's membrane, and a small layer of the corneal stroma.

After implantation of the graft into the eye’s anterior chamber, it is fixed with air or a gas-air mixture. Only a few interrupted sutures are placed on the corneal incision at the end of the operation. Corneal sutures can be removed 3 to 5 months after the surgery.

 

The advantages of performing posterior layered keratoplasty are:

  • Faster visual rehabilitation
  • Achieving higher visual acuity
  • Minimal induced postoperative astigmatism
  • Reduced risk of corneal transplant rejection
  • Reduced risk of intra- and postoperative complications compared with penetrating corneal transplantation.

Several factors may affect corneal transplant costs, including corneal processing costs, surgeon fees, medication and instrument prices, and ophthalmology clinic costs. Iran eye banks are non-governmental organizations that collect corneal tissues, process them, and distribute them to corneal transplant candidates in iran.

There are various clinics available in Iran that provide corneal transplants from 2500$ to 3000$. Iran has a much lower cost of corneal transplants compared with other countries. The medical equipment and facilities in Iran have made it one of the top destinations in the world for corneal transplants due to highly skilled and experienced surgeons. Contact us in Carefultrip for more information about eye surgery in Iran

 




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