Preparing for an operation

If the front part of the cornea is the reason for poor sight, such as with keratoconus or corneal dystrophy, only the epithelium and the stroma are replaced (the largest part of the cornea). This is referred to as Deep Anterior Lamellar Keratoplasty (DALK). Descemet’s membrane and the endothelium of the patient remain intact and form the surface support for the donor tissue. This technique ensures that the healing process is faster and the refractive result more predictable: the patient has a better chance of improved sight and the eye is stronger than before.

Post-operative check-ups

These appointments take place in Dr. Vryghem’s clinic or in St. Jans’ clinic, in the Ophthalmology department (2nd floor), depending on the consultation schedule. In some cases the check-ups are performed by the ophthalmologist who referred you to Dr. Vryghem.



At least 1 week before the pre-operative examination:

  • The patient’s GP must confirm that there are no contraindications for performing the procedure under local anaesthetic. An ECG must be taken as well as a blood test, unless these investigations have already been conducted during the previous six months.
  • Bring along the prescribed medication: Tobrex eye drops (see below), Tobradex eye drops (against infection), Homatropine eye drops 1% (for pupil dilation).

3 days before the procedure:

  • 3x/day 1 drop Tobrex in the eye to be treated.
  • Stop taking or replace blood thinners (to be agreed with GP)


The weekday before the operation:

  • Call 02/221. 99. 95 to find out the exact time of your operation.
  • Make arrangements with a driver to bring you and take you back home.

The day of the operation:

  • All medications may be taken in the morning with the exception of blood thinners.
  • If the operation is taking place in the morning, you should not eat or drink anything. If you are being operated on in the afternoon, you may eat a light breakfast.
  • No mascara or make-up
  • Bring with you to St. Jans Clinic: Tobradex drops (sealed bottle) and Homatropine drops.
  • The operation and preparation phase last about 1.5 hours. If there is any delay with patients before you, you will have to wait a little.

During the operation:

  • The anaesthetic consists of an injection next to the eye.
  • The ophthalmologist will take the time to explain everything to you, so that there are no surprises.
  • An eyelid retractor will keep your eyelids open, so that you don’t accidentally blink.
  • You won’t feel any pain.
  • The entire operation will last about 1 hour.

After the operation

  • You will not have to wear a pressure bandage after your operation.
  • The protective transparent eye shell will have to be worn at night for one week after treatment.
  • You must take the drops after the operation according to the following schedule:
    - Tobradex eye drops (anti-inflammatory):
    · 1 drop 4 x/day for +/- 12 weeks
    · 1 drop 3x/day for +/- 1 month.
    · 2 x/day long term.
    - Homatropine eye drops 1%:
    · 1 drop 2 x/day for +/- 3 weeks
    - Homatropine + Tobradex to be used at 5 minute intervals!!!!
  • The technique for using eye drops is very important:
  • Do not touch the eyeball. Gently pull down the lower eye lid, while looking upwards. Squeeze the drop inside your eyelid, and then gently close your eye.
  • Your vision will become clear in a matter of weeks. Any adjustment to your glasses will only be possible after at least 2 months.
  • If you suffer any serious pain or agitation, you should inform your GP via the Emergency Department of St-Jans Clinic: 02/221. 91. 11.
  • Do not plan any sport or other important activities in the days following the operation.
  • Avoid dusty places!
  • During the first 3 weeks: don’t rub your eyes!!!
  • During the first 3 weeks: no swimming.
  • During the first 2 weeks: don’t apply make-up.
  • Make a note of the check-up appointments with your ophthalmologist on the 1st, 3rd, 10th day, 3rd week, and the 2nd and 3rd month after the operation. The healing will be evaluated after about 2 months and 6 months.
  • After a graft, patients must often continue to use cortisone drops 1 to 2 times a day for the rest of their life.

If you want more information, or would like to make an appointment:
Contact us or call 0032 (0)2 741 69 99