Big Bubble Separation
Injecting a controlled micro-air bubble to split the thick stroma cleanly away from Descemet's membrane.
Corneal Transplant
Cornea Services
Deep Anterior Lamellar Keratoplasty (DALK)
DALK at Neera Eye Centre, Delhi — replace diseased stroma while preserving your natural endothelium for lower rejection risk.
Big bubble
Layer separation technique
Endothelium+
Your cells preserved
Keratoconus
Advanced stromal disease
Lower steroids
Reduced drop regimens
Service Overview
When corneal disease destroys the structural stroma but spares the innermost cell layer, a full-thickness replacement is an unnecessary risk. Deep Anterior Lamellar Keratoplasty is a highly specialized surgical procedure that swaps out the front and middle layers of the cornea while leaving your healthy endothelium intact. Our surgeons utilize advanced air-injection separation methods to isolate these delicate tissue boundaries. This protects you from major long-term graft failure complications.
What It Covers
Sub-Total Stromal Clearing
Removing the entirety of the structural corneal stroma down to the micron level.
Endothelial Preservation
Leaving your own single-cell endothelial layer completely undisturbed to eliminate endothelial rejection.
Anterior Structural Grafting
Adapting a healthy donor stroma and outer epithelium onto the preserved natural back wall.
Tension-Controlled Suturing
Stitching the outer circumference securely to promote rapid structural integration.
Who It Is For
Advanced Keratoconus Profiles
Individuals with progressive bulging whose deep stroma is thinned but whose back cells remain pristine.
Deep Anterior Scarring
Patients with deep stromal opacities caused by severe chemical exposure or old viral infections.
Stromal Dystrophies
Individuals suffering from genetic macular or granular conditions isolated strictly to the front layers.
How It Works
Air Dissection Staging
Micro-instruments track down into the deep stroma, where a precise bolus of air separates the layers.
Diseased Layer Removal
The scarred or thinned front and structural stromal layers are excised, leaving the microscopic back sheet clear.
Structural Re-Cladding
A donor stroma cleared of its back layer is laid onto the site and secured with precision micro-sutures.
Why Choose Us
Our surgical theater teams feature specialists explicitly trained in advanced big-bubble DALK mechanics. We operate with specialized high-frequency visualization systems to ensure safe separation at microscopic structural boundaries. Our clinics offer high success rates for keratoconus correction by combining structural safety with customized post-operative astigmatism tracking.
Frequently Asked Questions
Why is maintaining my natural endothelial layer so important?
The body's immune system primarily attacks foreign endothelial cells; keeping your own means long-term rejection risks drop close to zero.
Can a DALK procedure be converted to a full transplant during surgery?
If the microscopic back membrane tears during separation, our surgeons seamlessly transition to a full-thickness graft to protect the eye.
How long do I need to use steroid drops after a DALK procedure?
Because the rejection risk is significantly lower, the duration and dosage of steroid drop regimens are greatly reduced compared to full transplants.
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