Abstract: Objective To report clinical long-term efficacy of non-descemet stripping endothelial keratoplasty (EK) to treat graft failure after penetrating keratoplasty（PKP）. Design Retrospective cases series.  Participants 6 cases (6 eyes) who accepted EK because of graft failure after PKP in Aier Eye Hospitals from 2008 to 2010. Methods Clinical data of the participants after EK were reviewed retrospectively. The visual acuity, IOP, endothelial density, immune rejection, and complications were recorded. The follow-up time was (36.17±10.11) months. Main Outcome Measures Visual acuity, IOP, endothelial density, immune rejection, and complications. Results In all the 6 cases, corneal grafts restored clarity, visual acuities were improved and symptomes dispeared after EK. One graft dislocated at 1 day after operation, and was reattached by rebuble; one graft was noted with immune rejection at 5th month after operation, and medicine was effective; but immune rejection episodes was noted at another graft at 26th month because of irregular follow-up. The other grafts were clear during the follow-up period. Conclusion EK appears to be a good alternative surgical method for the patients of grafts failure after PKP, especially for high risk patients of immune rejection.

Key words: endothelial keratoplasty, penetrating keratoplasty, corneal decompensation