The latest news in corneal transplant for keratoconus is the anterior lamellar corneal transplant (DALK). This transplant consists in replacing the anterior portion of the corneal tissue (stroma). It is suggested in case of:
keratoconus (for cornea that have no damages in the Descernet membrane)
superficial corneal scars caused by traumas or infections.
The anterior lamellar corneal transplant can be performed with different techniques.
The most innovative technique is the big bubble DALK, where corneal layers are separated: this process requires high skills and expertise. Other techniques use a microkeratome, a excimer or a femtoseconds laser. All these processes have the same goal, that is removing the stroma till the endothelium in order to create an interface where it is possible to suture the transplanted portion. The surface should be uniform to guarantee a better vision quality after surgery.
The advantage of the lamellar corneal transplant (DALK) is that it has a lower rejection rate if compared to traditional transplant; this is because the transplanted portion is smaller.
Corneal tissue coming from the donor is sutured with the same techniques used in the full-depth corneal transplant.
Another great advantage is that suture removal can be done before, assuring a faster vision recovering compared to traditional corneal transplant. This is crucial for patients with keratoconus where anterior lamellar corneal transplant is performed, because they are young and active.
Dr. Badalà performs anterior lamellar corneal transplant with the DALK technique to cure keratoconus in Milan and Catania and holds courses on this innovative transplant process during the most important international conventions.