【Abstract】 Objective To report a case of acute cone corneal edema cured by deep lamellar keratoplasty (DLKP) at stage II after scar healing, and to analyze the mechanism and feasibility of the surgery. Methods A patient with acute cone corneal edema was treated with stage I radial keratotomy and stage II DLKP, and the naked and corrected visual acuity, refractive status, and slit-lamp examination results of the affected eye were observed, and the patient was followed up for 4 years. Results The patient was able to effectively control various symptoms in the acute phase of acute cone corneal edema by radial keratotomy, and the posterior elastic lamina of the cornea was able to be exposed completely in stage II DLKP, and no microperforation of the posterior elastic lamina occurred during the operation.The visual acuity remained stable at 0.4 naked eye and 0.8 corrected eye from 4 months to 2 years after DLKP.Conclusion Ruptured posterior elastic lamina of cornea due to acute cone corneal edema can recover its structure and function with some strength, creating an opportunity for stage II DLKP. [Keywords: corneal transplantation; deep lamellar corneal transplantation; acute cone corneal edema; penetrating corneal transplantation.