Huang OS, et al. - From 2004 to 2015, researchers quantified 540 eyes to assess the incidence and consequences of intraoperative Descemet membrane (DM) perforations during deep anterior lamellar keratoplasty (DALK) in this retrospective, consecutive, interventional case series. They noted 79 eyes with micro perforations and 15 eyes with macro perforation. The most common steps at which DM perforation occurred intraoperatively were observed during deep lamellar dissection (31.7%), air injection (26.7%), and suturing (20.8%). They involved a combination of intracameral air tamponade, stromal patching, fibrin glue, and suturing of the defect under the management of the DM perforations. They implied equivalent visual acuity outcomes in subjects with DM perforations intraoperatively vs those without DM perforations. They did not find any increase in the risk of graft failure, rejection, or subsequent surgery at postoperative years 1 and 3 too.