We describe special techniques to visualize the donor tissue in Descemet's stripping endothelial keratoplasty and to prevent the tissue or stripped recipient Descemet's membrane from dropping onto the retina. The techniques were used successfully to treat corneal decompensation in 3 consecutive cases with no iris or lens present. The results indicate that with careful planning and a good technique, aniridic aphakic patients can benefit from the rapid corneal rehabilitation provided by endothelial keratoplasty.