---
title: What is deep anterior lamellar keratoplasty (DALK)?
description: "Deep anterior lamellar keratoplasty DALK is a partial-thickness corneal transplant that replaces the front layers of the cornea while preserving the patient's own endothelium. ## How DALK is performed The surgeon removes diseased stromal tissue down to Descemet's membrane. A…"
url: "https://bluefinvision.com/knowledge-base/topics/treatments-procedures/what-is-deep-anterior-lamellar-keratoplasty-dalk/"
updated: "2025-12-31"
category: "Treatments & Procedures"
---

# What is deep anterior lamellar keratoplasty (DALK)?

Deep anterior lamellar keratoplasty DALK is a partial-thickness corneal transplant that replaces the front layers of the cornea while preserving the patient's own endothelium.

## How DALK is performed

The surgeon removes diseased stromal tissue down to Descemet's membrane. A matching donor layer is then sutured in place, leaving the inner cell layer intact.

- Used for conditions affecting the front cornea, such as keratoconus or some dystrophies
- Endothelial cells remain the patient's own, reducing rejection risk
- Sutures are usually removed gradually over months
- Vision improves as the graft clears and the surface regularises

## Benefits compared with full-thickness graft

Because the endothelium is preserved, long-term graft survival can be better. However, DALK is technically demanding and not suitable for every case.

- Lower risk of endothelial rejection and long-term failure
- Trauma is less likely to cause full-thickness wound rupture
- Some patients may still have residual irregular astigmatism
- Choice between DALK and PKP depends on disease depth and scarring