DALK is a technique in which all of the corneal tissue in front of Descemet’s Membrane is replaced leaving the recipients natural endothelial cell layer intact. DALK is particularly useful when conditions which affect only the front of the cornea such as Keratoconus or conditions which cause scarring are present as by leaving the recipient’s natural endothelial cells in place, the risk of corneal transplant rejection are lowered. DALK was pioneered as a technique by Dr Gerrit Melles, a Dutch Ophthalmologist.