Corneal Transplant – DALK (Deep Anterior Lamellar Keratoplasty)

Corneal Transplant – DALK (Deep Anterior Lamellar Keratoplasty) 

 DALK is a partial-thickness cornea transplant procedure that involves selective transplantation of the main body of the cornea known as the corneal stroma, while leaving the patient’s natural inner lining in place. The intention is to preserve the patient’s natural Descemet membrane and endothelium. As the lining is very thin (10 thousandths of a millimetre) the inner lining may not always be preserved in which case a full thickness graft (PKP) is performed. Similar to PKP, the DALK graft is secured with sutures and these are then selectively removed post-operatively. Close post-operative care and use of eyedrops is required for success. If the DALK is successfully completed and the patient’s natural inner lining is preserved the chance of lifetime graft rejection is significantly reduced. 

Only a select group of corneal diseases are treatable by DALK. These include diseases whereby the pathology is in the body of the cornea but the inner lining is still healthy. Examples include Keratoconus, corneal scars that are not full-thickness, and corneal stromal dystrophies.