Khanna Vision Institute Keratoconus

DALK or deep anterior lamellar keratoplasty

Cornea transplant for keratoconus involves the full thickness cornea replacement. Fukk thickness transplantation is also used for a variety of other corneal diseases like scarring, to restore the normal shape, clarity and therfore the function of the cornea. In all these cases the endothelium or the innermost layer of the cornea whcih pumps out fluid from the cornea is healthy. This gets sacrificed. DALK preserves this functional layer in the patient.

DALK

Deep anterior lamellar keratoplasty (DALK), is a newer surgical procedure that selectively removes the diseased anterior layers of the cornea. DALK retains the healthy innermost layer (endothelium). The inner layer is kept. The body
gets fooled and does not recognize the donor tissue, therefore there is less risk of rejection; the duration of steroid therapy can be decreased.

Procedure of DALK

This surgery requires even more skill than cornea transplantaion. It begins by dissecting the keratoconus cornea and retaing the innermost layer of desmets membrane on which endothelium is attached. Than a donor corneal button is prepared by removing the descmets mbrane and endothelium. This button is sutured in place.

Advantages of DALK for keratoconus are:

1. DALK is a closed eye surgery

2. The endothelium is preserved

3. Full thickness cornea transplant or PK can still be performed

Disadvantages.

1. It is technically challenging

2. Vision is slower to reach full potential ( 2-3 months)

3. Potential of scarring at the interface of donor cornea and patient's descmets membrane.

If you have been suggested to undergo cornea transplant schedule a consult with Trusted cornea Expert to see if the less invasive DALK may be an option for you.