Bilateral immediately sequential endothelial keratoplasty in bilateral bullous keratopathy

Pseudophakic bullous keratopathy is the presence of persistent corneal edema following intraocular lens implantation or cataract surgery. A 75-year-old lady presented to us with a right failed descemet stripping automated endothelial kerato-plasty (DSAEK) performed elsewhere and a left eye with decompensating bullous keratopathy. A decision was made to proceed with a right DSAEK in the first instance. A second corneal graft became available due to a late cancellation. After further deliberation, the patient agreed to have the procedure done in both eyes. She received an immediate sequential bilateral endothelial keratoplasty with a DSAEK in the right eye and a descemet membrane endothelial keratoplasty in the left eye. This bilateral sequential endothelial keratoplasty resulted in faster bilateral visual recovery without complications. We postulate this as a viable option to speed bilateral visual recovery; accepting further evidence is required to support our assertion and help generate formal clinical guidance.