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Aim To evaluate outcomes of deep anterior lamellar keratoplasty (DALK) in keratoconic eyes with previous hydrops. Methods In this retrospective, non-comparative study, keratoconic eyes with previous hydrops that underwent DALK were included. DALK was performed using a modification of Melles’s technique of optical recognition with pre-Descemet’s membrane dissection. Data on preoperative and postoperative uncorrected distance visual acuity and best spectacle corrected distance visual acuity (BSCVA), postoperative spherical equivalent (SEQ); keratometry and adverse events were recorded for all eyes. Results Ten eyes (10 patients) underwent DALK in keratoconic eyes with previous hydrops. Mean follow-u