Deep anterior lamellar keratoplasty (DALK) is a surgical procedure for removing the corneal stroma down to Descemet’s membrane. It is most useful for the treatment of corneal disease in the setting of a normally functioning endothelium.

Traditionally, penetrating keratoplasty (PK), which involves a full-thickness corneal graft, has been the treatment of choice for corneal stromal diseases. But PK can be complicated by graft rejection, irregular astigmatism and corneal opacification, thus resulting in visual impairment.

DALK offers an alternative procedure that may lessen those risks because the recipient Descemet’s membrane and endothelium are preserved. At the same time, DALK carries the potential danger of decreased visual acuity due to possible opacification at the interface layers.