Myerscough J, et al. - In this retrospective institutional cohort study, 591 eyes of 591 cases were examined to delineate the predictive risk factors for postoperative double anterior chamber formation with subsequent deep anterior lamellar keratoplasty (DALK). They observed keratoconus (67.2%) as the main implication for DALK. They also achieved pneumatic dissection in 72.9% of subjects. They observed postoperative double anterior chamber (AC) in 8.1% of cases. They found an association of age, intraoperative central DM perforation, type 2 bubble formation, and presence of scar in keratoconic and non-keratoconic corneas with an inclined risk of postoperative double AC formation. They did not record any relationship between manual dissection and double AC formation. They noted keratoconus with scarring, non-keratoconus with scarring, intraoperative central perforation, and type 2 bubble formation as the significant factors. They concluded scarred corneas of both normal as well as abnormal shape as independent risk factors for double AC formation after DALK.