DISCLAIMER! The information on this website is general information. Please discuss with your surgical provider your concerns and questions about the procedure. Your personal health information may differ from the information presented here.
Deep Anterior Lamellar Keratoplasty (DALK) is a selective form of corneal transplant that involves replacing the front (anterior) 95% of the cornea with a corneal donor graft. The most important advantage of DALK over a full-thickness transplant (PK) is that be keeping the original back layer of the cornea in place, there is no risk of rejection in that important layer (endothelium) of the cornea. Reducing the risk of endothelial rejection may prolong the survival of the corneal transplant and make replacement with a new transplant tissue unnecessary. The DALK transplant also heals faster and stronger than PK transplants. DALK surgery is technically more challenging than a penetrating keratoplasty, but is attempted in patients who are good candidates because of the benefits of selective transplantation. Recovery from DALK surgery is similar to recovery from penetrating keratoplasty with a patch worn overnight after surgery, a careful examination by the surgeon on the first day after surgery, and gradual return of good vision. Once the cornea is clear and has stabilized, corneal sutures are removed as needed and a pair of spectacles or a contact lens can be fitted for the sharpest vision. It is very important to protect the eye after DALK surgery because there is risk of damage with any kind of direct blow to the eye or face. Steroid drops are often taken for 1 year or longer to prevent corneal transplant rejection. We ask all patients to be vigilant with regard to the symptoms of corneal transplant rejection, which can be remembered with the mnemonic “RSVP” Redness, Sensitivity to light, decreased Vision, and Pain.