Perforation of the Descemet membrane is the most common intraoperative complication of deep anterior lamellar keratoplasty (DALK), noted to occur in 10% to 30% of DALK cases. This video elucidates the various steps at which intraoperative perforation is commonly encountered while performing DALK and how these can be tackled to prevent conversion and obtain a successful outcome. This video compilation of intraoperative DALK perforations will be a useful guide to corneal fellows in managing the various scenarios of DALK perforations.

Financial Disclosure: Drs. Noopur Parakh, Radhika Tandon, and Murugesan Vanathi disclose no financial relationships.