https://www.selleckchem.com/products/sbc-115076.html To compare the outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) with intrascleral haptic fixated IOL in a sequential and simultaneous approach. Tertiary Eye Care Centre DESIGN Prospective Randomized Comparative Study METHOD Patients with aphakic or complicated pseudophakic bullous keratopathy visiting a tertiary eye care Centre were included in the study. A total of 40 patients were randomized into two groups of 20 each. Group-1 had subjects who underwent scleral fixated intraocular lens implantation (SFIOL) by intrascleral haptic fixation technique followed by DSAEK (sequential procedure) with an interval of at least 3 months. Group-2 (simultaneous) had subjects who underwent DSAEK with SFIOL as combined procedure. Graft survival, endothelial cell loss (ECL), corrected distance visual acuity (CDVA) and need for any intervention like rebubbling were evaluated for both the groups at the end of 6 months. At 6 months the sequential group had significantly better CDVA of 0.62±0.17 logarithm of the minimum angle of resolution (logMAR) compared with 0.87±0.19 logMAR in simultaneous group (P=0.002). Group-1 had significantly better overall cumulative graft survival (100% versus 60%, P = 0.002), significantly lower ECL (P=0.006), lesser mean central corneal thickness (P=0.03), and significantly thinner donor lenticule (P=0.009). Rebubbling rate was significantly higher in Group-2 (P=0.025). The mean hyperopic shift was significantly more in Group-2 (P=0.02). The sequential procedure of SFIOL followed by DSAEK has better visual outcomes and graft survival as compared to simultaneous procedure in cases of aphakic or complicated pseudophakic bullous keratopathy. The sequential procedure of SFIOL followed by DSAEK has better visual outcomes and graft survival as compared to simultaneous procedure in cases of aphakic or complicated pseudophakic bullous keratopathy. Since recently the Victus femtosecond