 |
 |
 |
 |
 |
|
Deep Anterior Lamellar Keratoplasty (DALK) is a newer method of cornea transplant for anterior corneal disease such as keratoconus, corneal scars and stromal dystrophies. Only the diseased anterior layers of the cornea are replaced and the inner most layer of the recipient, the endothelium, is retained. Because the inner layer is retained, the body does not recognize the donor tissue, hence there is less risk of rejection and the corticosteroid medications can be discontinued after only 6 weeks.
Discontinuation of the corticosteroid medications lowers the risk of glaucoma or cataracts, which is a concern with use of corticosteroids. Since the corticosteroids are discontinued sooner, the wound heals more rapidly and the corneal sutures can be removed much sooner than with a full thickness transplant.
A lesser degree of suture related post-operative astigmatism has also been reported with DALK compared to full thickness grafts. The standard full thickness transplant lasts an average of 20 years and then often will fail and need to be repeated. By retaining the endothelial layer with DALK, the corneal transplant should last much longer.
