OBJECTIVE To retrospectively evaluate the outcomes of 124 consecutive deep anterior lamellar keratoplasties (DALK) performed by using dehydrated, 4 °C stored, and rehydrated lenticules. METHODS A total of 124 eyes of 109 patients, which had undergone DALK from August 11, 2000, to December 13, 2007, were included in our retrospective study; 88 cases were male and 36 female, with a mean age of 39.45±15.52 years (range 6-85). A total of 109 (87.9%) had keratoconus, 7 (5.6%) had deep or superficial corneal scar, 3 (2.4%) had epikeratophakia, 3 (2.4%) had pellucid degeneration, 1 (0.8%) a malignant pterygium, and 1 (0.8%) had a severe alkali burn. All the patients underwent ophthalmic examinations, including best-corrected visual acuity (BCVA), central ultrasound pachymetry, computerized topography, specular microscope endothelial cell count, and confocal microscopy. RESULTS The mean follow-up was 23.9±3.4 months. The mean preoperative BCVA was 0.16±0.18; the postoperative BCVA was 0.68±0.20 after 2 years. The mean preoperative central corneal thickness (CCT) was 439.4±10.5 µm; after 2 years, it was 532.1±9.7 µm. The mean preoperative endothelial cell count (ECC) was 2301.3±180.2 cells/mm2; after 2 years it was 1986.0±169.5 with a decrease of 13.7%. Baring of Descemet membrane (DM) during DALK was achieved in 112 (90.32%) eyes; 4 eyes (3.26%) had a large perforation of the DM with consequent PK. Small intraoperative perforation of DM during DALK occurred in 18 cases (14.52%). CONCLUSIONS The results showed that the method of preservation and distribution of dehydrated, 4 °C stored, and rehydrated lenticules is safe, cheap, and simple. Furthermore, it does not appear to influence the outcomes of the DALK surgery.