DALK

Deep anterior lamellar keratoplasty (DALK)

Deep anterior lamellar keratoplasty (DALK) is a newer surgical method of corneal transplantation for anterior corneal diseases like keratoconus, corneal scars and anterior dystrophies. In this procedure only the diseased anterior layers, the corneal stroma, is removed down to inner layers, Descemet’s membrane and endothelium, which are retained. It is most useful for the treatment of corneal disease in the setting of a normally functioning endothelium. Traditionally, penetrating keratoplasty (PK), which involves a full-thickness corneal graft, has been the treatment of choice for corneal stromal diseases.
But full-thickness corneal graft can be complicated by graft rejection, irregular astigmatism and corneal opacification, thus resulting in visual impairment. DALK offers an alternative procedure that may lessen those risks because the recipient Descemet’s membrane and endothelium are preserved.