Purpose: To describe a series of patients who underwent deep anterior lamellar keratoplasty
(DALK) after previous anterior lamellar keratoplasty (ALK) to improve their visual outcomes.
Methods: This is a retrospective case series of 9 DALK eyes (9 patients) with a history of
previous ALK and an unsatisfactory visual outcome. Surgery was performed in all cases at
least 3 years after ALK. Cannula big bubble, air viscobubble, and manual dissection
techniques were performed. Preoperative and postoperative best-corrected visual acuity …

There has been an evolution in the types of corneal transplants performed over the past 20
years. Selective replacement of the diseased corneal layer (s) is now the norm, rather than
replacement of the entire thickness of the cornea. Among the anterior lamellar keratoplasties
(ALK), deep anterior lamellar keratoplasty (DALK) is the mainstay surgery for corneal
stromal diseases with a functioning endothelium. DALK, while providing comparable visual
outcomes, offers substantial advantages compared to full-thickness penetrating keratoplasty …