---
title: What is DALK (deep anterior lamellar keratoplasty)?
description: "DALK is a partial-thickness corneal transplant that replaces the front layers while preserving the patient's own endothelium. It is often used for keratoconus and scars that spare the back surface. ## Surgical steps The surgeon removes the diseased stroma down…"
url: "https://bluefinvision.com/knowledge-base/topics/treatments-procedures/what-is-dalk-deep-anterio-lamellar-keratoplasty/"
updated: "2025-12-16"
category: "Treatments & Procedures"
---

# What is DALK (deep anterior lamellar keratoplasty)?

DALK is a partial-thickness corneal transplant that replaces the front layers while preserving the patient's own endothelium. It is often used for keratoconus and scars that spare the back surface.

## Surgical steps

The surgeon removes the diseased stroma down to the clear Descemet membrane. Donor tissue without endothelium is then sutured in place.

- Various techniques are used to separate layers safely
- Preserving the patient's endothelium reduces rejection risk
- Stitches remain for months and are removed gradually
- Glasses or lenses may still be needed afterwards for fine focus

## Advantages and limitations

DALK offers strong structural support with lower rejection rates than full-thickness grafts. However, visual recovery can be slower and surgery more complex.

- Useful for keratoconus, some scars, and stromal dystrophies
- Endothelial cell loss is minimised compared with PKP
- Interface haze may slightly reduce maximum vision in some cases
- Long-term follow-up remains important for suture management