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DALK / ALK

Deep Anterior Lamellar Keratoplasty

In Numbers

3000+ Total Cornea surgeries performed till time at LJ Eye Institute.

Demographics

Patients from Haryana, Punjab, Himachal Pradesh, J&K, & Rajasthan, trusts LJEI.

Technology / Innovation

LJEI is equipped with all the latest and rare Machines / Technology including AI.

Research

We preserve every single case study to handle any complex situation and publish research papers time to time.

DALK Surgery In India

What is DALK surgery?

DALK provides good long-term visual outcome for the patients with Herpetic Keratitis, Keratoconus, Stromal scars and corneal dystrophies. Often patients with compromised mental abilities, e.g. Down’s syndrome, Turner’s syndrome, etc., have ectatic corneal disease. In such patients, performing DALK has an advantage over PK, as it offers reduced risks of rejection and minimizes severe ocular damage secondary to self-trauma or eye rubbing.

With advancement in corneal surgical techniques, it is now possible to selectively remove the anterior layers from the cornea and replace it with donor tissue to restore its anatomy and function.

DALK is one such procedure wherein the host corneal endothelium is retained, and superficial corneal tissue is replaced with normal thickness donor tissue. As the host endothelium is retained there is minimum risk of rejection. Femtosecond assisted DALK is the most advanced form of anterior lamellar corneal transplantation which is also available at our centre.

Common indications for DALK include keratoconus and corneal scars. Patients with keratoconus are good candidates for DALK because they are typically young and have healthy endothelium.

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Cornea Helpline

Why To Choose LJ Eye Institute for DALK Surgery?

We have the most experienced surgeon in the region, Ddr. Vikas Mittal who performed more than 1000 DALK Surgery. Our graft rejection rate is less than 5%.

DALK can be performed in Corneal ectatic disorders like Keratoconus, Post LASIK Ectasia, Pellucid marginal corneal degeneration (PMCD). The bulged out cornea (forward bending making it a conical shape) in these disorders makes the focus in patient eye distorted and blurry. In this surgery, only front layers of cornea (stroma) is first cut with advanced corneal trephines and later dissected using special techniques and instruments. After this, same layers from a donated cornea is procured and then transplanted over patient’s eye. The ectatic or bulged out cornea is hence replaced by healthy cornea with appropriate shape. Use of Femtosecond laser in this surgery helps in avoiding use of trephine and various blades making it very accurate with diameter and depth of corneal layer transplantation. There is almost negligible risk of graft rejection and failure in this technique of cornea transplantation (Keratoplasty).

What is the difference between DALK and ALK?
Anterior lamellar keratoplasty (ALK) tissue, a partial-thickness anterior stromal graft, is processed by microkeratome upon request or provided for surgeon preparation. Deep anterior lamellar keratoplasty (DALK) is a full-thickness corneal tissue provided for surgeon preparation.
What is Deep Lamellar Endothelial Keratoplasty?
Deep lamellar endothelial keratoplasty (DLEK) is a surgical method of endothelial replacement that is performed through a limbal scleral incision that leaves the surface of the recipient cornea untouched.
What are the advantages of DALK?
Advantages of DALK over PK include better long-term graft survival, minimal steroid-related complications, and easier follow up, and the ability to use a lower quality donor. In addition, larger grafts can be transplanted without an increased rejection risk.
What is the recovery time for deep anterior lamellar keratoplasty?
Typically, the visual recovery time following a full-thickness transplant is one year. During this recovery period, patients are monitored closely to ensure normal healing and adjust sutures if needed to optimize the visual outcome.
Is keratoplasty surgery painful?
On the day of your cornea transplant, you’ll be given a medicine to help you feel calm or less anxious or a medicine that numbs your eye. Either way, you shouldn’t feel pain. Surgery is done on one eye at a time. The amount of time spent in surgery depends on your situation.
Why is the cornea special?
In addition to protecting the eye from outside infiltrates and ultraviolet radiation, the cornea is responsible for approximately 65% to 75% of the refraction of light as it passes through the eye. The cornea performs the initial refraction onto the lens, which further focuses the light onto the retina.
What is the age limit for corneal transplant?
There is no standard upper or lower age limit in countries such as India, Israel, the United Kingdom, and United States, though some eye banks have historically had upper age limits of 65 years.
Can you see without a cornea?
Your cornea serves an important function for your vision. It is more than a transparent cover over your pupil. The cornea also handles almost three-quarters of your eye’s focusing power. Functional eyesight would not be possible without a cornea, which is why they need to be in good shape.
Can the cornea repair itself?
As with many other body tissues, the cornea has an inherent ability to repair itself after incurring damage. Though in more severe cases, it may not be able to do so. In such scenarios, professional treatment may be necessary to effectively restore your eye health and visual acuity.
Can cornea be replaced twice?
Transplants can be repeated multiple times as long as there is a reasonable chance of success and the eye and patient can tolerate additional procedures. If the reason for vision loss is from the cornea alone, a corneal transplant should be successful in helping restore vision.
What are the complications of deep anterior lamellar keratoplasty?
The most common complication during DALK is perforation of the Descemet’s membrane during surgery. Tears or perforations occur in approximately 10 to 30 percent of the cases, and most commonly occur when a Type 2 bubble is formed. The risk is less in elderly patients, who tend to have a thicker Descemet’s membrane.
How long does a corneal infection take to heal?
Corneal ulcers often improve after 2 or 3 weeks of treatment. An ulcer in the centre of the eye might take longer. If the ulcer fails to heal, or leaves significant scarring of the cornea, your ophthalmologist might recommend cornea transplant surgery.

Cornea Surgeon Dr. Vikas Mittal

Performed 3000+ Cornea Transplant Surgeries

My Approach

1. Whether the patient really need cornea transplant or not. Although cornea transplant is most successful transplant in human body. Still transplant is transplant. If not that much necessary we will not do transplant.

2. If it really needed then we will see which technique is most appropriate for that patient. It is not a blanket that every cornea patient need same technique. So cornea transplant technique very from one patient to another. We see what is disease, type of transplant needed which technique will give highest success rate like 90% to 95%.

3. Follow Up : we have developed a strong follow up system. We take regular follow ups. So that rejection chances or infection chances are minimum.

I think how in compassionate manner I can treat this patients. I think like this is my family member and how I can treat my family member in best possible way.

DR. VIKAS MITTAL PROFILE
Cornea Surgeon Dr. Vikas Mittal

Available Cornea Treatments at LJEI

Cornea Transplant

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DMEK

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DSEK

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DALK

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Artificial Cornea (K-Pro)

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Corneal Cross-Linking (CXL)

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AMG

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Bowman-Stromal Inlay (BSI)

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Corneal Tattooing

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Infection/Ulcer Management

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Conjunctival Autografting

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SLET

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Therapeutic Penetrating Keratoplasty

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Optical Penetrating Keratoplasty

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Pterygium Surgery

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Available Cornea Treatments at LJEI

Cornea Transplants

DMEK Surgeries

DSEK Surgeries

C3R Surgeries

We feel proud to say that our doctors train various Cornea techniques to National and International doctors.

Most Advanced Eye Transplant Techniques Available

At LJ Eye Institute we use most advanced Eye Transplant techniques whichever is available in the world, which further help to increase the success rate. Where using traditional techniques the success rate is 70% to 75%, the new techniques increase the success rate to 90% to 95%.These advanced techniques includes DMEK, DALK, DSEK, using such techniques we need not to change whole Cornea and we change only One or required number of layers of Cornea.

Pioneers in Developing New Cornea Techniques and Modifying Existing Cornea Techniques

Technology @ LJEI

Technology Available For Cornea Treatments at LJEI

LJ Eye Institute employs ultra-advanced technologies for Cornea Transplant procedures.

  • We utilize Femtosecond LASER technology for Cornea Transplants, ensuring precision and accuracy compared to conventional blade methods.
  • Our facility is equipped with specialized equipment including Specular Microscope for assessing corneal power, Topography, Pentacam, Anterion, and OCT for comprehensive evaluation.
  • We integrate the latest available technologies from around the world to achieve the highest success rates in Cornea Transplants.
  • For pediatric cases, we have a dedicated spare system and have extensively researched Pediatric Cornea diseases, with publications in national and international medical journals.
  • LJ Eye Institute is at the forefront of Stem Cell Transplantation, particularly in the pioneering SLET technique, with numerous published papers showcasing our advancements and modifications in the field.

Still Have Questions?

BEST CORNEA HOSPITAL IN INDIA
BEST CORNEA HOSPITAL IN INDIA

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