Surgical Technique for Graft Exchange after DALK

In this surgical video, Dr. Ahmed Alshaarawy demonstrates a repeated deep anterior lamellar keratoplasty (DALK) technique by cauterizing and dissecting a scarred vascularized corneal stromal bed down to a transparent Descemet membrane. The 14-year-old patient who underwent a previous DALK surgery suffered from a scarred, vascularized graft due to corneal infection. The procedure consisted of baring the scar down to a transparent Descemet membrane and cauterizing the blood vessels. One month after surgery, the cornea was transparent and fully epithelialized, and vision had dramatically improved. The surgeons concluded that treating the scarred residual stromal bed by dissecting the scarred bed to a transparent Descemet membrane is an effective method to save the eye from the need for a penetrating keratoplasty (PK).

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