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RESULTS Visual acuity at presentation was 20/40. Endothelial cell densities were 2138 cells/mm (22% loss) and 1720 cells/mm (37% loss) at 3- and 12-months after DMEK, respectively. Two years after surgery, the best-corrected visual acuity remained 20/20 and the patient had no evidence of recurrence or limbal stem cell deficiency. CONCLUSIONS The use of sequential cryotherapy as a targeted intervention to destroy invasive corneal epithelial cells followed by staged DMEK surgery to replace damaged corneal endothelium was, in this case, an