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Updated: Jun 23, 2026

An “All-laser” Endothelial Transplant
Published on: July 6, 2015
Deep anterior lamellar keratoplasty on a previously failed full-thickness graft
S Ramamurthi1, K S Cornish, L Steeples
1Tennent Institute of Ophthalmology, Glasgow, United Kingdom. saraswathi_ramamurthi@yahoo.co.uk
Purpose:
To report a case of deep anterior lamellar keratoplasty (DALK) on a previously failed full-thickness graft in a case of herpetic keratitis.
Methods:
A 70-year-old patient with a history of penetrating keratoplasty for herpetic keratitis performed 30 years ago presented with blurry vision in her left eye. She had corneal stromal scarring secondary to herpetic keratitis. The endothelium was spared. We performed a DALK with big-bubble technique.
Results:
Postoperatively, corneal edema was noticed initially, which resolved in 3 months. Her best-corrected visual acuity is 6/12 in her left eye.
Conclusion:
DALK on a previous penetrating keratoplasty is a technical possibility when there is a functioning endothelium.

