An incomplete lens-iris diaphragm in a patient with corneal edema can complicate a descemet stripping endothelial keratoplasty (DSEK) procedure. The potential challenges may discourage the surgeon from performing DSEK in aphakic or aniridic eyes. In this presentation from Cornea Subspecialty Day, Dr. Tony Aldave argues that with a few modifications to the technique, DSEK can be performed effectively and safely in these eyes.