DALK or full thickness corneal

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Tim Payne
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DALK or full thickness corneal

Postby Tim Payne » Mon 04 Sep 2006 6:19 pm

Hi,

My left eye graft is still scheduled for 18th Sept and one thing I'm not sure about is what factors determine whether the surgeon opts for a DALK or full thickness procedure. When asking my consultant he says he will not know until I'm in theatre and will make the decision then. Obviously DALK seems to be the preferred procedure, re the rejection and recovery time advantages. I'm told the transplant material will be suitable for both procedures, so does it come down to the health of the endothelium or is it the surgical difficulty factor given DALK is newer and more tricky than full thickness???

cheers .... Tim.
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Postby GarethB » Mon 04 Sep 2006 6:52 pm

Hi Tim,

As the surgeon performs the DALK procedure, he will be looking out for things such as scaring and damage/weakness in the endotheleum to name but a few things he will look for.

If there is damage, the whole thickness will be removed and a full penetrating keratoplasty will be done.

Sometimes what can happen in sperating the layers (very rarely) the endothelium gets damaged so a full penetrating graft is done.

So in answer to your question it is a bit of both.

Regarding recovery times, if a DALK recovers quickly, it is quicker than a PK, however from the posts here the overall recovery time can be about the same 18 - 24 months for a stable cornea ready for correction with glasses or contacts.
Gareth

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Postby Matthew_ » Mon 04 Sep 2006 7:16 pm

Good luck, Tim
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Postby jayuk » Mon 04 Sep 2006 7:41 pm

Tim

Gareth is spot on!....Many do advise there patients that half way through the operation they may need to convert to Full thickness....for the reasons Gareth mentioned.......but there is also another reason.....the tools which are used for the DALK are extreme Precision....and if the Consultant does not use the correct tools to cut the layers and sub-layers he may go too deep...in which case he has to convert to full thickness........

HTH

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John Smith
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Postby John Smith » Mon 04 Sep 2006 9:53 pm

Yes, I was told that my DALK graft would medically heal very quickly, but optically, it would be just as slow, if not slightly slower than a PK graft.
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Postby Andrew MacLean » Tue 05 Sep 2006 7:37 pm

All the best tim

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Tim Payne
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Postby Tim Payne » Thu 21 Sep 2006 6:38 pm

It was a DALK !! Graft was on Monday, arrived back home yesterday. It went much better than I thought it would - although seem to have a mass of stitches and for some reason I was in theatre for well over 2 hours - told before hand the procedure was about a 1 hour. Not sure I'll be partying until 5:00 in morning come Sat but I will be celebrating with a glass or 2 of wine... Tim.
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Postby Andrew MacLean » Thu 21 Sep 2006 6:45 pm

Well done Tim

All the best

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Postby Sweet » Thu 21 Sep 2006 10:27 pm

Congrats! Hope all goes well!

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Postby jayuk » Fri 22 Sep 2006 10:13 am

How did you find the whole process? and how is the eye feeling now?
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