Uchio E, et al. - In this investigation involving 17 patients (18 eyes), researchers identified the therapeutic value of air-assisted manual therapeutic deep anterior lamellar keratoplasty (TDALK) in the treatment of fungal keratitis not curable by antifungal chemotherapy. Participants in the study were patients who were referred to Fukuoka University Hospital and treated surgically from January 2006 to April 2018. They included patients who were treated by air-assisted manual TDALK and in whom a diagnosis of fungal keratitis was confirmed by typical clinical findings and microbiological or histological analysis of corneal specimens, and who were poorly responsive to topical and systemic antifungal medication, while the lesion had not resulted in corneal perforation. Fusarium, followed by Candida and Aspergillus was the most common pathogen. For treating severe fungal keratitis, air-assisted manual TDALK can be effective. Furthermore, air-assisted manual TDALK could be an option to big-bubble DALK as it can provide ambulatory vision and maintain vision potential with less danger of intraoperative DM perforation.