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Intra-operative sequential steps of manual deep anterior lamellar keratoplasty in case of advanced keratoconus. (A) Keratoconus with paracentral ectasia; (B) lamellar dissection with the aid of intra-operative optical coherence tomography; (C) donor preparation; (D) at the end of surgery intra-operative optical coherence tomography showing well-apposed donor graft to host bed. OCT, optical coherence tomography.
