Deep anterior lamellar keratoplasty (DALK) is a type of corneal transplant procedure that involves removing the front layers of the cornea while preserving the innermost layer, the endothelium. This technique is primarily used for patients with keratoconus, a condition where the cornea becomes thin and bulges, distorting vision. DALK aims to replace only the damaged, superficial layers of the cornea, leaving the healthy endothelium intact.

The surgery is performed by excising the affected anterior layers of the cornea and replacing them with healthy donor tissue. Since the endothelial layer remains intact, the risks of transplant rejection are significantly reduced, and recovery times tend to be shorter compared to full-thickness corneal transplants. This technique allows for a more natural recovery of the cornea, and patients often experience improved vision post-surgery.

DALK is considered a less invasive option compared to full-thickness corneal transplant (penetrating keratoplasty) because it avoids the need to replace the inner endothelial layer. This technique is ideal for patients who have significant corneal scarring or thinning but still have a healthy endothelial layer. The procedure also minimizes the risk of complications such as graft rejection and other issues related to endothelial dysfunction.

Patients undergoing DALK typically experience a gradual improvement in vision over time. While recovery may take several months, the outcome is often favorable, with many patients achieving functional vision and avoiding the need for glasses or contact lenses. DALK has become a preferred method for treating keratoconus and other corneal diseases where the endothelial layer remains healthy.