Updates in anterior lamellar keratoplasty: the state of the debates

ABSTRACT

Introduction: Deep and Superficial anterior lamellar keratoplasty (DALK and SALK, respectively) are rapidly replacing penetrating keratoplasty (PK) as the treatments of choice for anterior corneal disorders worldwide. Nevertheless, significant disagreements remain which encompass nearly every aspect of both operations and whether there are better alternatives.

Areas covered: Here, we perform a comprehensive literature review of all articles published in the English language, indexed on Pubmed, and within the past 5 years on the subject of ‘anterior lamellar keratoplasty.’ From these articles, the most salient disputes are enumerated and presented.

Expert commentary: Presently, there is no consensus in the areas of graft preparation, instrumentation, or operative technique for DALK/SALK. As new evidence emerges, these debates may be clarified, or – instead – merely forgotten, as alternative surgical techniques arise to supplant ALK entirely.

KEYWORDS:

• Anterior lamellar keratoplasty
• Bowman layer transplantation
• DALK
• SALK
• review

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

No funding to declare.