Automated Lamellar Keratoplasty Eye Surgery (ALK)

Medically Reviewed on 12/13/2022
Keratoplasty Eye Surgery
For people with mild to moderate nearsightedness, automated lamellar keratoplasty may not be as accurate as other eye procedures.

Automated lamellar keratoplasty (ALK) eye surgery is a surgical procedure used to correct vision in people with severe nearsightedness (myopia) and mild degrees of farsightedness (hyperopia).

Though ALK takes around 24 hours to mend, vision stabilization may take a few weeks.

What is keratoplasty eye surgery?

Automated lamellar keratoplasty (ALK) is a non-laser lamellar refractive surgical procedure used to correct high-degree refractive errors.

The procedure is quick and typically takes less than an hour to complete.

2 types of ALK

  1. Superficial anterior lamellar keratoplasty: This involves the replacement of only the front layers of the cornea while leaving the healthy stroma and endothelium intact.
  2. Deep anterior lamellar keratoplasty: This involves attaching healthy tissue from a donor to replace the damaged portion of the cornea.

How is keratoplasty eye surgery done?


  • After a thorough evaluation of your medical history, your eyes are tested to measure corneal thickness, refraction, and pupil dilation.
  • You are advised to avoid wearing contact lenses for at least three days before keratoplasty eye surgery.

During the procedure

  • You should eat a light meal and take all of your prescribed medications as usual on the day of surgery. Avoid wearing eye makeup and having any bulky accessories in your hair, as it may interfere with the positioning of the head under the laser.
  • After local anesthesia is administered, a ring is fixed to the eye to keep it properly positioned.
  • A microkeratome (cutting device) is used to make a small incomplete flap across the cornea.
  • While still attached at one side, the corneal flap is folded back to reveal the sublayer of the cornea (layer of tissue below the cornea).
  • Another cut is made on the sublayer of tissue and the microkeratome is readjusted to match the calculated cut depth based on your contact lens prescriptions for vision correction.
  • The corneal flap is placed back over the eye for reattachment.


  • Depending on the circumstances, you can either leave the hospital the same day or stay overnight.
  • Eye drops and other medicines may be prescribed to help control infection, swelling, and pain.


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What are the pros and cons of keratoplasty eye surgery?


Some of the pros of keratoplasty eye surgery include the following:

  • The healing process is relatively rapid
  • Immediate results
  • Quick recovery time
  • An easy and comfortable recovery period
  • It takes less time for the return of stabilized vision


Some of the cons of keratoplasty eye surgery are as follows:

  • For people with mild to moderate nearsightedness, it may not be as accurate as other eye procedures
  • The outcome is difficult to predict
  • It may take several months for the stabilization of the vision correction
  • Tissue damage
  • An increased risk of developing an irregular astigmatism

What are the complications of keratoplasty eye surgery?

A few complications of keratoplasty eye surgery include:

  • Scarring
  • Infection
  • Glaring of vision
  • Astigmatism (irregular curvature of the cornea) 
  • Difficulty wearing contact lenses
Medically Reviewed on 12/13/2022
Image Source: Getty image

Hyperopic automated lamellar keratoplasty: complications and visual results NIH

Penetrating Keratoplasty American Academy of Ophthalmology

Cornea transplant Mayo Clinic