title: Clinical evaluation of Deep Anterior Lamellar Keratoplasty (DALK) for stromal corneal opacities.
abstract: BACKGROUND
  Corneal scars are commonly formed following many diseases of the eye like trauma, inflammation and infections. They lead to permanent diminution of vision which can be managed by Penetrating Keratoplasty (PK). PK is removing diseased as well as healthy tissues and is associated with many post-operative complications. Deep Anterior Lamellar Keratoplasty (DALK) is a relatively newer procedure which replaces only the diseased stroma, leaving the original corneal endothelium intact. This procedure is associated with lesser incidence of post-operative complications.
  
  
  METHODS
  The study was conducted at a large tertiary care centre. 10 patients with stromal corneal scars were subjected to DALK and results were analysed after 06 months. Poor quality donor corneal tissue of B- and C grade was used in all cases.
  
  
  RESULTS
  7 out of 10 patients (70%) undergoing DALK had post-operative visual acuity of 6/24 or better. 03 patients who did not have adequate recovery of visual acuity were due to over-riding of the graft in 01 case (10%), fungal keratitis in 01 case (10%) and interface haze in 01 case (10%).
  
  
  CONCLUSIONS
  DALK is a promising new technique for management of superficial corneal stromal scars using poor quality donor corneal tissue. Initial results are encouraging with minimal complications.
authors.affiliation: Senior Adviser (Ophthalmology), Base Hospital, Delhi Cantt, New Delhi 110010, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Mathur
authors.affiliation: Consultant (Ophthalmology), Army Hospital (R&R), New Delhi, India.
authors.forename: J K S
authors.initials: JK
authors.lastname: Parihar
authors.affiliation: Commandant, MH Jodhpur, India.
authors.forename: V K
authors.initials: VK
authors.lastname: Srivastava
authors.affiliation: Graded Specialist (Ophthalmology),158 BH, India.
authors.forename: A
authors.initials: A
authors.lastname: Avasthi
keywords: Descemet's perforation; Graft rejection; Interface haze; Lamellar keratoplasty; Superficial stromal corneal scars