{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:08Z","timestamp":1756425788287,"version":"3.44.0"},"reference-count":6,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,4,15]]},"abstract":"<jats:p>A patient with keratoconus underwent a penetrating keratoplasty (PK) in his right eye. This failed after 12 years following phacoemulsification surgery. A Descemet's stripping endothelial keratoplasty (DSEK) was carried out which failed and detached after 4 months. Subsequently, a second DSEK was performed which failed after 2 months but remained attached. This graft was retained in the cornea and a third DSEK button was placed without removing the failed DSEK graft. The cornea cleared well and patient\u2019s vision was 6\/9 at 18 months postsurgery. Optical coherence tomography showed the two DSEK grafts closely applied to each other and to the recipient cornea. Stripping a failed DSEK graft performed for a previous failed PK carries the risk of internal dehiscence of the PK graft\u2013host junction. This was avoided by placing the second DSEK graft on the failed previous DSEK graft with good visual outcome indicating that this option can be clinically considered.<\/jats:p>","DOI":"10.1136\/bcr-2016-218257","type":"journal-article","created":{"date-parts":[[2017,5,9]],"date-time":"2017-05-09T05:35:14Z","timestamp":1494308114000},"page":"bcr-2016-218257","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["A double Descemet\u2019s stripping endothelial keratoplasty on a penetrating keratoplasty"],"prefix":"10.1136","volume":"2017","author":[{"given":"Li Yen","family":"Goh","sequence":"first","affiliation":[{"name":"Ophthalmology, Kingston Hospital NHS Trust, Kingston upon Thames, London, UK"},{"name":"Academic Section of Ophthalmology and Visual Sciences, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Elalfy","sequence":"additional","affiliation":[{"name":"Academic Section of Ophthalmology and Visual Sciences, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noha","family":"Mohamed Ghoz","sequence":"additional","affiliation":[{"name":"Academic Section of Ophthalmology and Visual Sciences, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harminder","family":"Dua","sequence":"additional","affiliation":[{"name":"Ophthalmology, University Hospital, Nottingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,5,9]]},"reference":[{"key":"2025082801225422000_2017.may07_1.bcr-2016-218257.1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/BF01268097","article-title":"Causes of high astigmatism after penetrating keratoplasty","volume":"85","author":"Hoppenreijs","year":"1993","journal-title":"Doc Ophthalmol"},{"key":"2025082801225422000_2017.may07_1.bcr-2016-218257.2","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2008.305"},{"key":"2025082801225422000_2017.may07_1.bcr-2016-218257.3","doi-asserted-by":"crossref","first-page":"28","DOI":"10.4103\/0974-9233.61214","article-title":"Deep anterior lamellar keratoplasty: indications, surgical techniques and complications","volume":"17","author":"Karimian","year":"2010","journal-title":"Middle East Afr J Ophthalmol"},{"key":"2025082801225422000_2017.may07_1.bcr-2016-218257.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2009.06.021"},{"key":"2025082801225422000_2017.may07_1.bcr-2016-218257.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2007.09.021"},{"key":"2025082801225422000_2017.may07_1.bcr-2016-218257.6","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.preteyeres.2015.07.002","article-title":"Progress in corneal wound healing","volume":"49","author":"Ljubimov","year":"2015","journal-title":"Prog Retin Eye Res"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-218257","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:23:05Z","timestamp":1756369385000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-218257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,9]]},"references-count":6,"alternative-id":["10.1136\/bcr-2016-218257"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-218257","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,5,9]]}}}