Anterior Lamellar Corneal Transplant or DALK

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.

This transplant can be done with several 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.


Luca Formica, Catania

Votazione: Eccellente
Problem: Keratoconus
I met Dr. Badalà with a vision of 20/100 in each eye as a result of advanced Keratoconus. Other doctors did not advice for surgery. In two months I overcome my fear and I underwent corneal transplant surgery.
Immediat... Keep on reading this reviewely before entrance in the operating room, Dr. Badalà and the nursing team were joking with me, making the atmosphere nice and relaxed. The surgery was under general anesthesia and lasted two hours.
Upon recovery the eye was a little itchy and burning, anyhow totally bearable. I was dischenged from the hospital the next day without a patch, but wearing a protecting eye shell. The most beautiful thing in my life was getting my vision back 20/30 days after surgery and rediscovering things I had forgotten.
Today, 5 years after surgeries (I had corneal transplant in both eyes) I have 20/20 vision with a very simple pair of glasses that I use only at night for driving and I see well and enjoy details that I have not seen for a long, long time.
Obviously, I’m careful with my life but I have a normal life, I do everything I like to do, like play soccer, go biking, go to the gym, play videogames, and so on.
I’m appreciative of the gift of vision, for which I thank Doctor Badalà and his team.