Deep Anterior Lamellar Keratoplasty (DALK): A Precise Procedure for Corneal Reconstruction

 Deep Anterior Lamellar Keratoplasty (DALK): A Precise Procedure for Corneal Reconstruction

Subheading: Understanding the Technique, Indications, and Recovery Process of DALK

Introduction: Deep Anterior Lamellar Keratoplasty (DALK) is a specialized surgical procedure performed to reconstruct the cornea, the transparent front part of the eye. DALK is an advanced technique used in cases where only the outer layers of the cornea are damaged or diseased, while the innermost layer called the endothelium remains healthy. By preserving the endothelium, DALK offers numerous advantages over traditional full-thickness corneal transplantation.

What is DALK? Deep Anterior Lamellar Keratoplasty (DALK) is a partial-thickness corneal transplantation technique that involves the removal and replacement of the damaged or diseased layers of the cornea, while leaving the healthy endothelium intact. During the procedure, the surgeon carefully removes the anterior layers of the cornea, including the epithelium and the stroma, and replaces them with healthy donor tissue. By preserving the recipient's endothelium, DALK reduces the risk of graft rejection and improves long-term outcomes.

Indications for DALK: DALK is commonly used to treat conditions that affect the corneal stroma while sparing the healthy endothelium. Some of the indications for DALK include:

Keratoconus: A progressive condition characterized by thinning and bulging of the cornea, leading to distorted vision.

Corneal scars: Scar tissue that affects the clarity of the cornea, usually resulting from infections or injuries.

Corneal dystrophies: Inherited disorders that cause abnormal deposits or changes in the cornea.

Corneal ectasia: Thinning and steepening of the cornea after refractive surgery, such as LASIK.

Pellucid marginal degeneration: A condition that causes thinning of the cornea, resulting in irregular astigmatism.

Benefits of DALK: DALK offers several advantages over traditional full-thickness corneal transplantation, known as penetrating keratoplasty (PKP):

Reduced risk of graft rejection: By preserving the healthy endothelium, DALK lowers the risk of graft rejection and improves long-term graft survival.

Reduced risk of intraoperative and postoperative complications: DALK avoids complications associated with penetrating the entire cornea, such as wound leaks, endothelial damage, and glaucoma.

Faster visual recovery: Patients who undergo DALK often experience faster visual recovery compared to PKP, as the healthy endothelium maintains corneal clarity and stability.

Improved structural integrity: DALK provides better biomechanical stability to the cornea, reducing the risk of postoperative complications and ectasia.

The DALK Procedure:

Preoperative assessment: The ophthalmologist evaluates the patient's eye condition, measures corneal thickness, and ensures that the endothelium is healthy.

Donor tissue preparation: The healthy corneal tissue from a donor is carefully dissected to remove the endothelium and Desc