Deep lamellar keratoplasty provides a safer and successful alternative to penetrating keratoplasty for keratoconus patients but remains a challenging procedure. Endothelial graft rejection is absent after DALKP. However, stromal graft rejection, although very rare, does occur.

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Amniotic tissue prepared in a commercial laboratory or by properly qualified eye bank personnel may be used for AMT in eyes with persistent corneal epithelial defects with minimal risk of microbial keratitis in the first postoperative month.

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Decreased endothelial cell density is uncommon after resolution of acute hydrops, although morphologic changes may be present in a majority of cases.