Deep Anterior Lamellar Keratoplasty (DALK)
Deep Anterior Lamellar Keratoplasty (DALK) is a corneal transplant procedure that utilizes techniques to preserve the two innermost layers of the cornea (Descemet’s membrane and Endothelium) and replace the three outermost layers of the cornea (Stroma, Bowman’s layer, and Epithelium) with donor tissue.
The cornea has five layers:
1) Epithelium: the outermost layer of the cornea, which serves as a boundary against infection and foreign materials such as dust and water.
2) Bowman’s layer: a transparent layer made up of strong collagen fibers.
3) Stroma: a collagen layer that comprises the majority of the cornea.
4) Descemet’s membrane: a thin layer of tissue that protects the eye from infection and holds the endothelium in place.
5) Endothelium: the thin, innermost layer of the cornea. It is made up of cells (endothelial cells) that are responsible for pumping water out of the cornea.
There are many advantages of DALK over other types of corneal transplants. One is that the eye is not fully opened during the surgery, therefore there is less risk of complications during surgery. A second benefit is that a portion of the patient’s own cornea is preserved (the innermost two layers), so there is a decreased risk of corneal rejection and less need for lifetime steroid use. One of these two layers in particular, the Descemet’s membrane, provides extra structural support to the cornea after surgery.
A Deep Anterior Lamellar Keratoplasty (DALK) is useful in conditions that affect the anterior (front) portion of the cornea such as Lattice Dystrophy, Granular Dystrophy, Avellino Dystrophy, Macular Corneal Dystrophy, and Keratoconus.
Our doctors perform DALK and are happy to discuss the procedure with you if you are a candidate.
The information contained within these pages is intended for informational purposes only and does not take the place of consulting a physician.
Created by and for New York Cornea in association with Columbia University Medical Center.
Caring for your corneas since 1988.