Hematocornea is a rare but potentially sight-threatening complication of corneal transplantation. In this video, we present the surgical management of a 45-year-old female who developed hematocornea, two years following penetrating keratoplasty. In such case, DALK can be performed following PK to allow selective removal of the diseased stroma while leaving the functional endothelium intact. Video authors: Drs. Massimo Busin, Giuseppe Giannaccare, Andrea Lucisano, Vincenzo Scorcia and Angeli Christy Yu.