What is Deep Anterior Lamellar Keratoplasty (DALK)

DALK is a partial-thickness cornea transplant procedure that involves selective transplantation of the corneal stroma, leaving the native Descemet membrane and endothelium in place. A trephine of an appropriate diameter is used to make a partial-thickness incision into the patient's cornea, followed by pneumodissection or manual dissection of the anterior stroma.

A corneal transplant is a sophisticated operation and best in the hands of an experienced corneal surgeon.

DALK (Deep anterior lamellar keratoplasty) is a partial thickness graft that preserves the TWO inner most layers of the cornea: Descemet’s membrane and the endothelium. The goal of the procedure is to retain the endothelial layer of the host. This layer keeps the cornea clear by removing fluid from the bulk of the cornea. Retaining this layer avoids the risk of potentially blinding Graft Rejection that can occur with Penetrating Keratoplasty. If the endothelial layer is normal, then it is worth preserving. The procedure requires technical skill and involves dissecting the cornea to almost 95% thickness, and removing the top layer. A donor corneal button is prepared by removing Descemet’s membrane and donor endothelium. The donor graft is then stitched to the host. The cornea takes a little longer to clear but visual results can be similar to those of a penetrating keratoplasty.

Deep Anterior Lamellar Keratoplasty (DALK)