What is DALK?
Deep Anterior Lamellar Keratoplasty. As the name suggests it is a type of keratoplasty or corneal transplantation. There have been traditionally two types of replacement of cornea with a cadaver cornea. Full thickness graft referred to as Penetrating Keratoplasty or PK. The other type less commonly used was Lamellar keratoplasty or LK, This is a partial thickness cornea graft. Learn about the Structure of Cornea.
DALK is hybrid between LK and PK. It goes deep where no LK has ever been before (language sounds like Star Trek, huh). It just stops short of the Descemets’ and endothelial layer.
Indications for the DALK procedure
DALK is indicated when the inner layers of the cornea is healthy but the superior layers have a pathology.
In Keratoconus eye disorder the endothelium works but the collagen layer is weak. Keratoconus eye disease is present in younger people. DALK is a good choice in them. If the cornea has ruptured like in Hydrops than DALK may not be possible.
Corneal Dystrophies and superficial scars not treatable with PTK are good candidates for DALK. Scars may varied etiology like post PRK scars, post traumatic or post infective. In cases of herpetic scars it is recommended to wait six months after the active infection has subsided.
Steps in DALK Surgery
Advantage of DALK Transplant
Disadvantage of DALK
DALK is a great procedure if you qualify for it. There is one way to find out. Schedule a consult with Cornea specialist Rajesh Khanna, MD by calling (310) 482 1240.