Purpose: evaluating  the alterations in endothelial cell density and gauge the visual results after performing deep anterior lamellar keratoplasty .
Setting: Memorial institute for ophthalmic research and KasrAlainy Faculty of Medicine, Cairo University
Methods:  A prospective interventional study where 30 eyes from 30 patients were enrolled to undergo deep anterior lamellar keratoplasty (DALK).The technique employed either the big bubble technique or lamellar dissection . The main goal was to evaluate the variations in endothelial cell density by utilizing a non-contact specular microscope before surgery, after 6 weeks and after 6 months. Furthermore, the study also aimed to evaluate the visual outcomes measured before the surgery, at 6 weeks postoperatively, and at 6 months postoperatively.
Results: Significant decrease  in endothelial cell density was observed during the entire follow-up duration of the study. The preoperative cell density decreases significantly from 2905.5±119.5 to 2374.8±113.5after 6 weeks (p=0.000). Subsequently there was significant decline to 1894±113.2 at 6 months (p=0.000). Regarding visual outcome ,it  showed significant improvement.
Conclusion: DALK is associated with significant decrease in the endothelial cell density at 6 weeks and 6 months postoperatively and visual outcomes show significant improvement.