Purpose: To report the results of a new approach to the 2-stage surgical management of coexisting visually significant corneal opacities and cataract. Methods: A retrospective analysis of eyes with corneal opacities and cataract that were surgically treated with simultaneous penetrating keratoplasty and cataract surgery, followed by secondary intraocular lens (IOL) implantation after removal of corneal sutures, was conducted. The parameters used for assessment were the following: mean percentage of graft endothelial cell loss after IOL implantation, deviation of the postoperative mean spherical equivalent from the target refraction, and mean uncorrected distance visual acuity (UDVA). Results: Twenty-nine eyes were included in the study. The mean baseline UDVA was 1.94±0.46, and the mean baseline best-corrected distance visual acuity was 1.56±0.42. The mean interval between the 2 surgical interventions was