【Abstract】 Objective To investigate the clinical efficacy of anterior chamber gas-mediated deep lamellar corneal transplantation with repeatable manual excision. Methods This modified deep lamellar corneal transplantation was performed in 41 cases (41 eyes), including those with turbidity involving the deep stroma due to recurrent episodes of keratitis (22 eyes), those with turbidity involving the deep stroma due to chemical or thermal burns (12 eyes), those with completed conical corneas (4 eyes), those with corneal dystrophy involving the deep stroma (2 eyes), and those with corneal degeneration (1 eye). The regression of the affected corneal implants, prognosis of the original ocular surface disease, corneal interlaminar transparency, neovascularization, closure of the posterior elastic lamina rupture, visual acuity, and intraocular inflammatory reaction were observed by slit-lamp microscopy in the postoperative period. Results Of the 41 affected eyes, 31 had complete exposure of the posterior elastic lamina, 6 had partial stromal scarring that could not be completely separated from the posterior elastic lamina, and another 4 had perforation when separating the deep stroma and posterior elastic lamina in the near central portion of the eye. Severe anterior chamber toxicity occurred in one eye postoperatively. No other serious complications occurred during the follow-up period. Conclusion Anterior chamber gas-mediated maneuver with split paracentesis for deep lamellar corneal transplantation is safe and effective